Full Name
*
First Name
Last Name
E-mail
*
Phone Number
-
Area Code
Phone Number
Department, College or Organization
*
Classification
*
Please select one from the following:
Faculty
Staff
Teaching Assistant
Graduate Student
Undergraduate Student
Academic Department
Administrative Office
Student Group
Visitor
Other
Office Location
Event Information
Proposed Purpose
*
Please select one from the following:
Meeting
Seminar
Workshop
Conference
Presentation
Equipment Training
Student Group Meeting
Other
Event Title
Number of people attending (Macomb campus)
*
Event Start
*
-
Month
-
Day
Year
Date Picker Icon
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Event End
*
-
Month
-
Day
Year
Date Picker Icon
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Repeat Event?
Yes
No
Repeat Event Day(s)
Weekly, Monthly, Bi-weekly or actual dates
Room Information
Type of Room (For Electronic Classrooms and Technology Based Conference rooms, a faculty/staff member must be present)
Electronic Classroom
Conference Room
Office space (to be used by faculty/staff for meetings with students)
Office space (to be used by students for livestream classes)
Horrabin Classrooms (Not for regularly scheduled classes)
Horrabin 7 (Capacity=30) (Codec)
Horrabin 21 (Capacity=48)
Horrabin 26 (Capacity=38)
Horrabin 44 (Capacity=64)
Horrabin 59 (Capacity=47)
Horrabin 78 (Capacity=80)
Horrabin 82 (Capacity=38) (Codec)
Horrabin 83 (Capacity=25) (Codec)
Horrabin 111 (Capacity=25) (Computer lab)
Horrabin Hall Conference Rooms
Horrabin 001
Horrabin 023 (Plant Room)
Horrabin 030
Horrabin 048 (Seymour Center)
Horrabin 060
Horrabin 113E
Other
Horrabin Hall Office Space
Horrabin 49
Horrabin 113A
Horrabin 113B
Horrabin 113C
Will you need a connection?
*
Yes
No
Remote Site Room Number
Will you need a video conference room in Quad Cities?
*
Yes
No
Number of people attending (Quad Cities campus)
*
Video Conference Location
Please select one from the following:
River Front
Quad Cities Complex
Party Responsible for connecting and ending Video Conference.
Name
E-mail
Technical Assistance
Yes
No
Type of Technical Assistance Required?
Please select one from the following:
Make Connection Only
Make the connection and Shut Down Equipment
Setup Equipment (Computer, Smartboard, etc)
Setup Equipment and Connection
Other
Is Special Room Setup Required?
Please select one from the following:
Yes
No
Special room setup for events in Horrabin Hall 1 are due at least 10 days prior to the event. Setup and technology needs are due at time of request.
Number of individuals expecting for event
Please select style of setup:
Banquet
Boardroom
Classroom
Hollow Square
Theatre
U-Shaped Style
Additional Information
Type of tables for event needed:
Round
Barrack
No Tables
Submit
Print Form
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