Primary Contact

Primary Contact Name  

Telephone   (xxx) xxx-xxxx

E-Mail Address  

Department Name  

Department ID Number  

Professor/Instructor

Professor/Instructor Name

Telephone (xxx) xxx-xxxx

E-Mail Address

Setup/Cleanup Time

Approx. Set-up time (if applicable)

Year --20132014 / Month --JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember / Day --12345678910111213141516171819202122232425262728293031   Hour --120102030405060708091011 : Minute --000510152025303540455055 AM/PM --AMPM

Approx. Clean-up time (if applicable)

Year --20132014 / Month --JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember / Day --12345678910111213141516171819202122232425262728293031   Hour --120102030405060708091011 : Minute --000510152025303540455055 AM/PM --AMPM

Check Equipment needs:

Computer

LCD Projector

Bringing Own Laptop

PowerPoint

Other A/V Equipment Needs:

Please contact Facilities Services for tables, extra trash cans and recycle bins.

Alternative Operating System

I plan to use a Mac.

By checking the above box, I acknowledge that it is my responsibility to contact OIS at (919) 843-8884 to ensure the adaptability of the presenters' and event coordinators' materials to a Windows-based system.

Vendor & Trade Show Information

Select this box if the business you represent manufactures or provides products and/or services used in patient care and/or research?

If so, you must contact vendorrelations@unch.unc.edu for approval before reserving this room.

If your company organizes events for vendors, it is not prohibited from providing refreshments at the event, provided that the following guidelines are met:

1. It must be clear that  your company, the event organizer, is offering and paying for the refreshments, as opposed to any of the vendors.
2. Your company is ultimately responsible for the vendors at the event, including providing each vendor with a copy of the Policy on Vendor Relationships Related to Biomedical Research or Patient Care.  The vendors cannot give out food or other gifts of any nature or any value, even those trivial value.