Computer/Media Lab Appointment Request
Please note:
  • Appointment dates must be requested at least 24 hours in advance but no more than 1 month in advance. 
  • One-on-one appointments are limited to 1 hour. Follow-up meetings (same topic covered) are scheduled for 30 minutes and are limited to 2 sessions. 
  • Multiple dates for the same month may be requested on the same form if "Reason for Use" is the same.
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Email *
Name *
Phone Number *
Email Address *
Requested Appointment Date *
MM
/
DD
/
YYYY
Back-Up Appointment Date
MM
/
DD
/
YYYY
Requested Appointment Time *
Time
:
Reason for Use *
A copy of your responses will be emailed to the address you provided.
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