Room Reservation and Facilities Request Form
This service is available to Polytechnic University faculty and staff ONLY.
We suggest you keep a copy of this form for your records.

A. General Information - Required (Fill in Entirely)


Event Name and Description:
Date Of Event: / /
Setup duration prior to start:
EXACT Time of Event: am pm
End Time of Event: am pm
Post event cleanup duration:
Number of Attendees:
Room requested: Note: Reserve the auditorium to reserve the foyer.
Contact Person:
Extension:
Department:
  Student organization
Admissions related activity
B. Facilities - x3020 No Facilities Set-Up Required.
Number of Chairs:
Number of Tables:
Portable Blackboard :
Other:

Seating Arrangement:
Square U-Shape Classroom
LC433 - 18 Seats Max
LC400 - 35 Seats Max
Silleck Lounge - 25 Seats Max
LC433 - 14 Seats Max
LC400 - 31 Seats Max
Silleck Lounge - 20 Seats Max
LC433 - 25 Seats Max
LC400 - 85 Seats Max
Silleck Lounge - 30 Seats Max



Restaurant Style Rectangular
LC433 - Not Available
LC400 - 95 Seats Max
Silleck Lounge - 90 Seats Max
LC433 - 20 Seats Max
LC400 - 30 Seats Max
Silleck Lounge - 20 Seats Max


Other:

C. Media Support - x3934 No Media Support Set-Up Required.
Podium Event Recording    
Podium with microphone TV/VCR    
Overhead Projector Video Projector System    
Screen Slide Projector
Other

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