Date of use requested:

Official Meeting Time:

Time of use requested:

Official Meeting Title:

Requestor's Name:

First Name:
*
Last Name:
*

Requestor's E-mail:

Phone:

* Mail Code:

or Organization Name:

Address:

COE Affiliation (if any):

Equipment Information:

Overhead Projector(s)	Extension Cord
VCR & Monitor	Standard Podium
Easel(s)

Microphone Handheld Podium Lapel
Other (please specify):

Room Preferred:

Please indicate your first and second choice of rooms in the boxes below. (Click here if you need information about the various rooms that comprise the Conference Center.) Note that final determination of the assigned room will be made by Conference Center staff based on availability.

First Preference:

Second Preference:

Room Layout:

Number of Chairs:

Layout:

Rectangular Fanned Out Standard
Classroom Theatre Horseshoe

Registration Table(s):

( # Inside Room)

Display Table(s):

( # Inside Room)

Food Service Table(s):

( # Inside Room)

Other:

Please Note:

This is not a confirmation of your room request. Your request will be reviewed in the next 72 hours. A response from the Conference Center Coordinator will be provided thereafter. Requests are NOT confirmed until the Conference Center Coordinator sends a notification to the requestor.

* Required field