Room Reservation Form

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Date*

MonthDayYear
Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Email*
example@example.com
Company*
Company Status*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
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Event Details
Meeting/Event Name*
Campus*
Room Selection - Mt. Pleasant Campus*
Room Selection - Harrison Campus*
Date*

MonthDayYear
Number of Attendees*
Groups can start setting up for events at 7:30am, but the event cannot begin until 8am.
Event Start Time*

:HourMinutesAM/PM Option
Event End Time*

:HourMinutesAM/PM Option
When do you need to be in the event space to begin set up?*

:HourMinutesAM/PM Option
Do you require room set up assistance?*

YesNo
Room Setup Request (Be VERY specific)
Do you require IT Support? IT Support is not available until 8am and includes basic services such as connecting to Mid's wireless network, general computer lab support, general video conferencing support, and general conference room AV support.*

YesNo
IT Support Request (Be VERY specific)
Will food and/or refreshments be served at your event?*

YesNo
Will caterers need building access before and/or after the event?*

YesNo
Do you have any additional requests?
Please read the INCLEMENT WEATHER AND EVENT CANCELLATION INFORMATION and EXPRESSIVE ACTIVITY POLICY.
I confirm that I have read and understand the*

INCLEMENT WEATHER AND EVENT CANCELLATION INFORMATIONEXPRESSIVE ACTIVITY POLICY
Signature*
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