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Room Reservation Request Form

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Room Reservation Request Form Powered By Docstoc
					Office Use Only
Approved:
Building Supervisor:
Date:

                   Martin C. Jischke Building Room Reservation Request Form

To reserve a room please complete this form and return it to Linda Young, 2130 Jischke Honors
Building (or fax: 294-2970). The contact person you list, will be sent an email notice regarding
your request.

Name of Organization/Person (Please print):

Date(s) requested:

Start time:                      am or pm

End time:                        am or pm

Estimated attendance:

Description of Event:




Type of space needed:

    1.   Lounge Area
    2.   Room 1113 (moveable tables and chairs)
    3.   Room 1151 (moveable tables chairs; media equipment)
    4.   Room 1155 (moveable tables and chairs)

Type of media equipment requested:
(Portable media equipment available.)

Room Preference:

                                     Statement of Responsibility:

As sponsors of this activity, we agree to abide by the university and building policies that apply
to use of this space. We assume responsibility of clean up and guarantee payment for any
damages incurred as a result of our use of the building.

Name of Contact:

Email address:

Telephone Number:

ID# :

Group Name:

Account Number:
                        (in case of damages)

				
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Jun Wang Jun Wang Dr
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