Room Request Form

Basic Information

Requester Name

First*

Last*

Sponsoring Department Name (no acronyms please)*

Requester Email*

Requester Phone*

FOAPAL Information

Fund*

Org*

Program*

Host Name (if different from requester)

First*

Last*

Event Location

195 Farmington Avenue*

Academic Building, Library*

Main Building*

Musculoskeletal Institute*

Munson Road*

Outpatient Pavilion*

Outside Space*

University Tower*

Event Information

First Choice Event Date/Time

Date*

Start Time*

End Time*

Second Choice Event Date/Time

Date*

Start Time

End Time

If Meetings or Practices Are on Random Dates and Times, Please Submit Them Below:

Room Configuration

Room Set-Up Type

Total Number of Tables

How Many of Above Tables Will Be for Food?

Number of Chairs

Comments/Special Instructions

Other Equipment Needed (Fees May Apply). How Many of Each?

Extension Cord

Power Strip

Coat Rack

Waste Containers

Installation of Additional Software for Library T2C2 Rooms

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Room Request

See topics forAdministrative Support Services

Useful Resources