Notice of Visitor/Housing Request

Notice of Visitor/Housing Request
This form is for anyone planning to visit the Cary Institute for any length of time. Please complete the form in its entirety.

After submitting this form, you will receive an e-mail confirmation at the address that you provided below; a copy will also be sent to the appropriate staff members. Forms are processed during the regular work week, Monday through Friday.
Host*

First NameLast Name
Host E-mail Address*
example@example.com
Visitor Name*

First NameLast Name
From which state will you be traveling to Cary?*
Visitor Title*
Institution Affiliation*
Institution Address*
Visitor E-mail*
example@example.com
Visitor Website
Visitor Cell Phone Number*

Area CodePhone Number
Visitor Emergency Contact Name*
Visitor Emergency Contact Phone*

Area CodePhone Number
Purpose of Visit*
Visit Start Date*

MonthDayYear
Date
Visit End Date*

MonthDayYear
Date
Vehicle Make
Vehicle Model
Vehicle Color
Vehicle License Plate
Visitor Needs

Desk Assignment / Placard / Phone ExtensionDisplay Visitor Information on IntranetDesk Setup / Stationery SuppliesHR Orientation / PackageSafety Orientation FormPhotographMailboxComputer AssistanceLibrary UsageLab Usage (Safety Protocol)Building / Lab Keys ($15 deposit)Vehicle Parking StickerCary Account NumberCary Vehicle (subject to availability & fees apply)
On Campus Housing Requested (subject to availability & fees apply)*

YesNo
Please complete the following if you require on campus housing:
Arrival Date*

MonthDayYear
Date
Arrival Time*

:HourMinutesAM/PM Option
Departure Time*

:HourMinutesAM/PM Option
Departure Date*

MonthDayYear
Date
Visitor Gender*

MaleFemaleNon-Binary
Is spouse or family accompanying guest?*

NoYes
Total number of visitors in party*
Hospitality Basket? $6 Basket Charge*

NoYes
Bill housing/basket charge to*

Invoice personal check or cash accepted - No credit cardsCary Account
Cary Account Number
Location Preference*

Armand Lovelace Lower ApartmentArmand Lovelace Upper ApartmentConover HouseHart CottageLee Lovelace HouseSmith House
Room Preference*

Single RoomDouble Room, with roommateNo Preference
Keys*

Leave keys on the shelf in the entryway of the Tozer Ecosystem Science BuildingGive keys to host before arrivalVisitor will pick up keys from Housing Coordinator during business hours (8:30-4:30)Other
Notes/Special Requests/Questions
Please verify that you are human*
Should be Empty: