Fitze Study Room reservation form

Fitze Study Room reservation form

Please refer to the TPL Fitze Study Room Policy to make sure your meeting qualifies to be held in the Fitze Study Rooms
Organization Name:
Purpose of meeting:
Study Room Reservation Request:
Anticipated number of attendees:
Maximum Capacities: Large Fitze Study Room (6), Small Fitze Study Room (2)
Frequency:
- Date Requested:
  
  MonthDayYear
  2 digit month, 2 digit day, 4 digit yearDate
- Time Requested:
  
  :HourMinutesAM/PM Option
  Until
  until :HourMinutesAM/PM Option
- ** You will not be able to "Submit" this request if a date or time is missing
- Please enter a list of Custom Dates with Start/End times denoted for each:
- ** You will not be able to "Submit" this request if this field is left empty
- Contact Person:
  
  TitleFirst NameLast Name
- Mailing Address:
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Primary Contact Number
  
  Area CodePhone Number
- Secondary Contact Number
  
  Area CodePhone Number
- Contact Email:
  example@example.com
- Statement of Responsibility:
- Signature:
- I have read the TPL Fitze Study Room Policy. I understand and agree to the terms thereof. SPECIAL NOTICE: (1.) This submission does not guarantee the use of the Study Room (2.) Please cancel any room reservation if unable to keep the date/time requested. By selecting "Yes" below, I understand and agree that my electronic submission of this form constitutes my acceptance of responsibility and agreement to the terms and conditions set-forth.
- Should be Empty: