RESERVATION FORM

Last Name:

First Name:

Phone #:

E-Mail:

Office #:

You are:

Under Grad Student Grad Student Faculty Staff

Equipment:

Check here if you need instruction on using the equipment. Please plan to come by our office at least 30 minutes before your reservation time.

If you are reserving a laptop, please indicate which of the following devices you will need:

	CD-ROM		Zip Drive		Floppy Drive
	Remote Mouse		Extra Battery		Network Card

Presentation Room: ETC

Select the type of reservation:
One Time	Weekly Recurring (Same days over several weeks)	Multi-Day Span (Several Days in a Row)

What day do you need the equipment, or if this is a recurring or multi-day reservation what is the first day.?

Month:

Day:

Start Time:

End Time:

If this is a weekly recurring reservation, please check the days it will recur, and enter the date of the last occurrence. If it is a multi-day span reservation, please enter the last day of the reservation:
Days for Weekly Recurring Reservations:			Last Day:
Monday	Tuesday	Wednesday
Thursday	Friday	Saturday
Sunday

For what purpose do you intend to use the equipment?

If any files need to be installed, you need help with equipment set up, help with equipment use, or if you have other comments, leave them here:

Page Last Updated: Thursday January 19, 2006 08:53:48 AM -0600 Page Created By: Tom Ryan