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). Once a room has been assigned to you, it will be your responsibility to arrange audio/visual requirements through the LRC.

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 20
PHR 2.214 Conference/Lecture; Capacity 23
PHR 3.106 Lecture; Capacity 136
PHR 3.110 Conference; Capacity 25
PHR 3.112 Lecture; Capacity 16
PHR 3.114A Conference; Capacity 10
PHR 3.114B Conference; Capacity 10
PHR 3.114C Conference; Capacity 6
PHR 3.114D Conference; Capacity 8
PHR 4.114 Lecture; Capacity 52
PHR 5.108 Lounge; Capacity 20

General Purpose Classrooms (not ours)
PHR 2.108 Lecture; Capacity 127
PHR 2.110 Lecture; Capacity 165
PHR 2.114 Conference/Lecture; Capacity 60
PHR 2.116 Computer Classroom; Capacity 48 (24 computers)

18 January 2005
College of Pharmacy at UT Austin
Comments to: pharmacy@www.utexas.edu