VERC Room Booking Request Form

Fields denoted by an asterisk (*) are required.

Requestor Information
Your Name Your Name First Last
Your Email
Your Phone Your Phone - ### - ### ####
Extension
Instructor Information
Instructor's Name Instructor's Name First Last
Instructor's Email
Instructor's Phone Instructor's Phone - ### - ### ####
Instructor's Extension
Booking Information
Booking Purpose
Date Requested Date Requested / MM / DD YYYY
Start Time Start Time : HH MM AM/PM
End Time End Time : HH MM AM/PM
Occurrence

Occurrence Single Mulitple
Number of Learners
Class type
If "Other" please specify:
Additional Software Requested
Any new software additions/requests need to go through a requirements validation process in order to ensure the software is compatible with the lab. Once the requirements have been met, we will need 30 days to install/configure the software.

The Requester is responsible for all costs associated with obtaining additional software. Enter "None" if you do not require any additional software.

To view the Pre-Installed Software scroll to the top of this page.
Is technical set-up assistance required for your event? (15 minutes prior to event start time)

Is technical set-up assistance required for your event? (15 minutes prior to event start time) Yes No