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 *
Your answer
Today's Date *
MM
/
DD
/
YYYY
Phone Number
Your answer
Is this reservation for an outside Department/Group *
Name of Group or Committee Meeting *
Your answer
Description of Group or Committee Meeting *
Your answer
Approximate Number of People *
Your answer
Building and Room Preference *
Your answer
Alternate Building and Room
Your answer
Name of Person Responsible for Cleanup (Note: You are responsible for cleaning up and resetting the room when you are finished) *
Your answer
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
MM
/
DD
/
YYYY
Day of the Week
Starting Time
Time
:
Ending Time
Time
:
FOR CONTINUOUS MEETINGS ONLY
Date You Need a Room
MM
/
DD
/
YYYY
Frequency of Meeting
Your answer
Day of the Week
Starting Time
Time
:
Ending Time
Time
:
Is this Meeting for an Entire Semester
If not, What is the End Date
MM
/
DD
/
YYYY
FOR OFFICE USE ONLY
Confirmation from the Chemistry Office
Your answer
Date of Confirmation
MM
/
DD
/
YYYY
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