Toggle navigation Load unfinished survey Resume later default Caution: JavaScript execution is disabled in your browser or for this website. You may not be able to answer all questions in this survey. Please, verify your browser parameters. MD Program Interest Group Room Booking Request Form (This question is mandatory) Student/Group Info Event: Student Name/Class: Student Email: Purpose/Event: Date of Event Date format: mm-dd-yyyy Open date/time selector Format: mm-dd-yyyy 1900-01-01 2187-12-31 MM-DD-YYYY (This question is mandatory) Start Time of Event Please be clear and specify AM or PM (This question is mandatory) End Time of Event Please be clear and specify AM or PM (This question is mandatory) Building Preference: Choose one of the following answers MDCL HSC WRC NRC Other: Number of Attendees at each site: For any site(s) not involved in the event, you may leave them blank. Only numbers may be entered in these fields. Hamilton NRC WRC Technologies needed: Check all that apply Videoconferencing Smart Board Sites Participating in the Videoconference PLEASE NOTE: You need to book at least 1 week (5 business days) in advance to ensure your VC will be processed. This will guarantee IT support staff can be scheduled for VC setup, otherwise support for the event cannot be guaranteed. No last minute requests can be arranged. Check all that apply Please select at least one answer Hamilton NRC WRC NRC Contact Info A name and email of a participating student must be provided, or the room will not be booked. Answers of "TBA or TBD" will not be processed. NRC Contact Name NRC Contact Email WRC Contact Info A name and email of a participating student must be provided, or the room will not be booked. Answers of "TBA or TBD" will not be processed. WRC Contact Name WRC Contact Email Comments (This question is mandatory) Is this a booking change? Yes No (This question is mandatory) Booking Confirmation Number: This is the number given to you when you first received confirmation of your booking. (This question is mandatory) Furniture Setup Required: Yes No Location/Room #: Furniture Required: Only numbers may be entered in these fields. # of Tables: # of Chairs: # of Poster Boards: # of Flip Charts: # of Sign Stands: Please specify a payment option: Please note that for IG events held on weekends, housekeeping and room charges may apply and the student group will be responsible for payment through FHS room bookings NOTE: Bookings and furniture set up cannot be directly charged to FHS research accounts. Requests submitted using a research account will not be processed. (ie: Accounts beginning with 8) Choose one of the following answers Account # Cheque Cash No answer (This question is mandatory) Account #: If furniture setup is required, an account # must be provided. Submit Load unfinished survey Resume later Please confirm you want to clear your response? Exit and clear survey ×
