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In order to enhance  the learning experience of the UofM students  an Event  Coordinator  from the  department is normally  required to facilitate   student/preceptor room placement/set up  at the beginning of each session. The event coordinator  can  leave the facility after the students/preceptors are settled in their rooms.

 
 
Event Coordinator Name
 
 
Booking/ Tour  requested by:  
 
 
Email
Note: A copy of this form will be emailed to this address upon completion.
Send me this email as HTML instead of plain text.
 
 
Phone Number 
 
 
Company/Firm
 
 

Name of instructor(s)/Tour Lead

 
 
Title/Name of Session
 
 
Department
 
 
Type of Program
 
 
Session/Department Coordinator
 
 
Type of session
 
 

Date of  Event

mm/dd/yyyy
 Calendar
 
 
Setup Time Startmm/dd/yyyy
 Calendar  
 
 
Session Start Timemm/dd/yyyy
 Calendar  
 
 
Teardown Start timemm/dd/yyyy
 Calendar  
 
 
Alternate Date and Time
 
 
Comments/ Additional Booking Information


(you may add the  date and time of  the recurring sessions of the same type)

 
 
 Submit as HTML
 
 
Duration of the booking
 Hours
 
 

Number of rooms required 

 
 For Tour bookings please indicate the number 0
 
 
If the intended use will impact adjacent rooms due to noise or other disruptions, the booking must include ALL rooms.Would you like to book all rooms ?
 
 
 
Type of Room (Press CTRL to select multiple rooms)
 
 

Other Services   (click "None"  for a tour)

 
 

Goals and objectives of the session

 
 
 Submit as HTML
 
 

Number of participants

 
 
Type of Equipment (Press CTRL to select multiple equipments)
 
 

Support needs for (Press CTRL to select multiple choices)

 
 
Supplies (Press CTRL to select multiple supplies)
 
 
Would you like to use the Online exam system ?
 
 
Internet access is ONLY available upon request, do you need access to the internet?

Please specify how many internet computers you require for this session.