Department of Chemistry and Biochemistry Room Reservation Request Form
Form is for non-course requests. Requests for rooms for courses, contact Amy Taylor-Perry.

Requests must be made at least four (4) business days in advance.
Email address *
Name *
Today's Date *
MM
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DD
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YYYY
Phone Number
Is this reservation for an outside Department/Group *
Name of Group or Committee Meeting *
Description of Group or Committee Meeting *
Approximate Number of People *
Building and Room Preference *
Alternate Building and Room
Name of Person Responsible for Cleanup (Note: You are responsible for cleaning up and resetting the room when you are finished) *
Will food be served? (ALL FOOD AND BEVERAGE TRASH MUST BE CARRIED OUTDOORS TO THE DUMPSTER BEHIND THE A&S STOCKROOM LOADING DOCK, AND TABLES AND CHAIRS WIPED DOWN) *
Signature *
Required
FOR ONE TIME MEETINGS ONLY
Date You Need a Room
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Day of the Week
Starting Time
Time
:
Ending Time
Time
:
FOR CONTINUOUS MEETINGS ONLY
Date You Need a Room
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/
DD
/
YYYY
Frequency of Meeting
Day of the Week
Starting Time
Time
:
Ending Time
Time
:
Is this Meeting for an Entire Semester
Clear selection
If not, What is the End Date
MM
/
DD
/
YYYY
FOR OFFICE USE ONLY
Confirmation from the Chemistry Office
Date of Confirmation
MM
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DD
/
YYYY
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