Category

Conference Room Reservation Form

Use this form to request a Department of Medicine conference room for a meeting or event. You will receive a confirmation within 24hours of your request. Reservations are subject to availability and may not be reserved by telephone.

Note: Remember to include time for set-up and clean-up in your request. There will be an administrative charge of $100.00 should room not be retuned in adequate condition upon review by a Department of Medicine representative.
 
Person Making Request
Division
Telephone
E-mail
Person responsible for event
Telephone
E-mail
Date of event , (mm/dd)
Recurring Event One-Time
Weekly
Monthly
Until:
Note: Remember to include time for setup and cleanup in your request.
Start Time
End Time
Event Title
Number of participants
AV requirements lap top connectivity/screen
none
Room selection Please note Conference rooms:
1) Only have internet connectivity and a screen.
2) They should be selected based on the number of attendees.
3) Please do not move furniture.
Richard-Cournand Library: up to 18 attendees
Kimberg Conference Room: 13-30 attendees
Atchley-Loeb Conference Room: 31-40 attendees
Account number
(By indicating account number I authorize administrative direct charge of $100.00 should conference room not be returned in adequate condition upon sign out review by Department of Medicine representative.)