SUBMISSION FORM FOR AD HOC CLASSROOM RESERVATION
Please fill out the requester information below. Indicate your classroom needs from the list that follows. Every blank must be completed so that we can process your request properly. A response will be forwarded to the email address you provide within 48 hours of receipt of your request. Note: ad hoc reservations for rooms can only be made following the first day of class so that we can schedule regularly scheduled classes in our classrooms.

Name of Requester:
Faculty
Staff
Graduate Student for: (Faculty / Organization)
PharmD. Student for: (Faculty / Organization)


E-mail Address:
Phone:
Division:
Date needed:
Time Starting:
Time Ending:
Describe intended use:

Below, please provide a description of your room needs (lecture versus conference style, number of participants, video conference or audio/visual needs). Once a room has been assigned to you, it will be your responsibility to arrange audio/visual and/or video conference arrangements through the LRC.

Note: To see a more detailed description and photos of each room, visit our classroom options page.

Description of needs:
Seating Capacity :

If you know that any of our rooms listed below would meet your needs, please check the appropriate box(es). Note that this does not guarantee availability of that room, but will help us to identify a room matching your needs.

Our Rooms
PHR 2.208 Conference/Lecture; Capacity 32
PHR 2.214 Conference/Lecture; Capacity 18
PHR 3.106 Lecture; Capacity 136
PHR 3.110 Conference; Capacity 30
PHR 3.114A Conference; Capacity 10
PHR 3.114B Conference; Capacity 12
PHR 3.114C Conference; Capacity 8
PHR 3.114D Conference; Capacity 8
PHR 4.114 Lecture; Capacity 51
PHR 5.108 Lounge; Capacity 20
PHR 5.214 Lecture; Capacity 28

General Purpose Classrooms (not ours)
Note: Student organizations must reserve these rooms through the dean of students.
PHR 2.108 Lecture; Capacity 133
PHR 2.110 Lecture; Capacity 137
PHR 2.114 Conference/Lecture; Capacity 57
PHR 2.116 Computer Classroom; Capacity 44 (22 computers)

23 August 2012
College of Pharmacy at UT Austin
Comments to: pharmacy@www.utexas.edu