Reservation of Computing Facility

RESERVATION OF COMPUTING FACILITY

College of Social Sciences and Interdisciplinary Studies

DATE SUBMITTED:

FACILITY REQUESTED (BLDG&RM):

NAME OF REQUESTOR:

DEPARTMENT & ZIP:

TELEPHONE: EMAIL ADDRESS:

Complete instructor information only if it differs from that of the requestor's information.

NAME OF INSTRUCTOR:

DEPARTMENT & ZIP:

TELEPHONE: EMAIL ADDRESS:

SOFTWARE and HARDWARE REQUIRED:

NUMBER OF STATIONS REQUIRED:

RESERVED FOR (check one of the following):

Meeting	Provide Description
Instruction	Course Title & Sec:
Maintenance (ITC Only)	Explain:
Other	Explain:

SPECIFY DAY(S) and TIME(S) FACILITY is NEEDED:

Monday

Tuesday

Wednesday

Thursday

Friday

Start Time:

End Time:

Start Date: End Date:

SPECIAL NOTES:

I understand that my department is responsible for providing 10 reams of printer paper to the Dean's Office prior to the beginning of my first class session. I have verified that my software and hardware requirements are consistent with the software and hardware found in the specified lab. I agree to comply with University policies, ethical use of computing, and legal statutes.

INSTRUCTOR'S SIGNATURE: DATE:

DEAN'S OFFICE USE ONLY:

Date Received: __________ Initials: _____ Approved: _____ Denied: _____

Facility Reserved: ________________ OnTime: __________ Requestor Notified: __________

Notes: _____________________________________________________________