Conference Room Request Form
Friedman Brain Institute - Hess 9th and 10th Floors
Reservations for individuals/groups not located on Hess 9th or 10th floors must be within normal business hours (9:00am-5:00pm, Monday through Friday).
We do not allow recurring reservations for individuals/groups not located on Hess 9th or 10th floors.
If the room is not in use within 15-minutes of reservation start time, reservation will be automatically cancelled
All rooms have a PC, wall projector, a telephone and a white board with markers.
Only HDMI connections can be used in these rooms (VGA is no longer supported). You must supply your own webcams and adaptors.
Please initial: I understand that the Neuroscience staff and staff of the Friedman Brain Institute (Hess 9th and 10th floors) have priority for use of our rooms and that, if needed, my reservation may have to be cancelled to accommodate them. I will receive 24 hour notification.
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Please initial
Please initial: I understand that no food is permitted in this conference room.
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Please initial
Please initial: I agree to make sure the projector is turned OFF after use.
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Please initial
Please initial: I agree to use the room for only the time allotted and to vacate when my reservation time ends.
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Please initial
Please initial: I understand that furniture cannot be moved in or out of the conference rooms. My department will be charged if anything is broken and requires replacement, or if cleaning, for which we would normally be charged, is required.
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Please initial
Provide Fund Number:
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XXXX-XXXX-XXXX
Room Request:
Hess 9-121 (Seats 18 ppl - 10 around table, 4 on each side of room)
Hess 10-121 (Seats 16 ppl - 10 around table, 3 on each side of room)
Hess 10-122 (Seats 18 ppl - 10 around table, 4 on each side of room)
Hess 10-101 (seats 20 ppl - 10 around table, 5 on each side of room)
Date(s) Requested:
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/
Month
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Day
Year
Date
Start Time End Times
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1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
15
30
45
Minutes
AM
PM
AM/PM Option
Until
until
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
15
30
45
Minutes
AM
PM
AM/PM Option
Date(s) Requested:
/
Month
/
Day
Year
Date
Start Time End Time
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
15
30
45
Minutes
AM
PM
AM/PM Option
Until
until
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
15
30
45
Minutes
AM
PM
AM/PM Option
Brief Description of Event & list of recurring dates (if applicable)
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0/100
Number of People to be Accommodated
*
Contact Name:
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First Name
Last Name
Contact Phone Number
*
-
Area Code
Phone Number
Contact Email
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Confirmation Email
example@mssm.edu or example@mountsinai.org
Contact Location
Hess 9th Floor, Room 000
Alternate Contact Name:
First Name
Last Name
Alternate Contact Phone Number:
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Area Code
Phone Number
Alternate Contact Email:
example@example.com
Please initial: I understand that if I or the group for which I am reserving this room for don’t follow these guidelines, that we may be prohibited from making future reservations.
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Please initial
Please verify that you are human
*
I understand that everyone will use hand sanitizer when entering the room. We will also clean the room with sanitizer wipes when we are done using the room.
*
Please initial
Save and Continue Later
Send Request
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