HOSPITAL CLASSROOM SERVICES

Reservation Form

Please fill out fields:

Email
Contact Name
Department
Subdepartment
Other (not on list)
Campus Address
Campus Zip
Phone
Fax

Each meeting request must be submitted separately unless the meeting is ongoing at the SAME TIME each day requested and the SAME INFORMATION applies to all scheduled dates.

DATE(S) REQUESTED
Begin Time
End Time

Room Preference


# of Participants
Purpose
Other
Audience
Meeting Title
Moderator/Instructor
Special Needs (not A/V)
	This Request is for Room Reservations only - A/V Equipment and projectionists requests are handled through LRC and must be requested separately after confirmation is received.

You may also print this request and fax it to 5-1547. Questions can be directed to Heather Desmarais at 5-0167.

University of Michigan Health System
1500 E. Medical Center Dr.   Ann Arbor, MI 48109    734-936-4000
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Last Updated:
11/19/2008