Health Sciences Learning Center Atrium Use Request Form
Before submitting this form please review the HSLC Atrium Guidelines. 
Requests can be submitted on a six-month rolling horizon from the date of your event.
Requests submitted outside of this window will not be processed.

Also review the HSLC Vendor Policy:

Displays, meetings, and events held in the commonly shared space in the Health Sciences Learning Center (HSLC) may not distribute promotional or educational materials provided by industry (defined as manufacturers, servicers, and other vendors of pharmaceutical, medical, and veterinary medical devices and supplies, commercial products, and medical and veterinary medical testing companies).

Small signs acknowledging contributors are allowed but may not include industry logos or allow individual industry displays.

Events held in commonly shared space in Health Sciences Learning Center may not include distribution of industry-funded gifts to students.

If you will also need a lecture hall or meeting room as part of your event and have not requested it yet, please submit a reservation via your online Room Reservation System.  Accounts available for Health Sciences & UW Health staff, faculty, and student.
https://it.med.wisc.edu/room-reservations/
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Email *
Date(s) *
Please enter the date(s) you would like to use the atrium
Setup Start Time
 *
*What time will you start your setup?
Time
:
Event Start Time
 *
*What time does your event begin?
Time
:
Event End Time
 *
*What time will your event end?
Time
:
Cleanup/Teardown and Exit Time
 *
*What time will the space be reset and ready for the next group? 
**If you intend to use UW Physical Plant equipment (tables and chairs) and your event is on a Friday or Saturday, please write in the notes and inform Room Reservations staff that your Cleanup End Time is Monday, as Physical Plant does not pick up furniture on the weekends.  This is important as it will effect weekend reservations.
Time
:
Title of event *
Description of event *
Please give a detailed explanation of your intended use of the atrium.  ie Tables outside a lecture hall, poster board session, luncheon event.
Additional Space *
Did you need additional space, meeting rooms, lecture halls, or registration table areas?
Number of attendees *
Will you be serving food *
Please put the name of your caterer in the Other box if known
Will you be having alcohol at your event? *
On site contact name *
Contact person day of event
On site contact phone number *
Contact person day of event
On site contact email  (NetID Email i.e. Bucky@wisc.edu) *
Contact person day of event
Event coordinator name *
Contact for event planning details.  Might be the same as on site contact above.
Event coordinator phone number *
Contact for event planning details.  Might be the same as on site contact above.
Event coordinator email  (NetID Email i.e. Bucky@wisc.edu) *
Contact for event planning details.  Might be the same as on site contact above.
Event coordinator department *
If this is a student sponsored event please indicate that below
Do you plan to have equipment brought in from an outside supplier? *
ie A-Z rental, UW Hospital Plant Engineering, UW Truck Services
Is this a fundraiser? *
Will you be displaying any signage or posters? *
Do you need additional equipment? *
ie Tables, Chairs, Extra Custodial Items.
Is your event sponsored by a vendor? *
Have you read the HSLC Atrium Guidelines & Vendor Policy? *
Refer to link at top of form to read
Do you plan to have vendors attend your event? *
If you will be having vendors will they have a display?
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A copy of your responses will be emailed to the address you provided.
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