Reservation Request Form

Primary Contact

Primary Contact Name (Required)

Telephone (Required)

(xxx) xxx-xxxx

E-Mail Address (Required)

Department Name (Required)

Department ID Number (Required)

Professor/Instructor

Professor/Instructor Name

Telephone

(xxx) xxx-xxxx

E-Mail Address

Number of Rooms Requested (Required)

Number of Participants per Room (Required)

Do you need a specific room/lab? If so, please list:

Click here for a list and descriptions of available rooms supported by OIS.

This is a(n): (Required)

Event
Course

Event or Course name/number (Required)

Start Date/Time (Required)

/ /

End Date/Time (Required)

/ /

Setup/Cleanup Time

Approx. Set-up time (if applicable)

/ /

Approx. Clean-up time (if applicable)

/ /

Is this a recurring event? If so, please list additional dates:

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.

I will need A/V support at these times: (Required)

You may select more than one by holding down Ctrl+clicking.

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:

It must be clear that your company, the event organizer, is offering and paying for the refreshments, as opposed to any of the vendors.
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.

Please note that room reservation does not include the surrounding areas such as lobby areas and Atrium. You must request such space when reserving a room if you are planning on utilizing these spaces.
If serving food or beverages, be sure to clean and dispose of all trash following the event.
All rooms must be left clean and in proper order.
Please note: The deadline for room reservation requests for Fall courses is July 1. The deadline for Spring requests is November 1.
View our website for more details on reserving rooms: http://www.med.unc.edu/ois/services/room-reservations
For questions, please call the Scheduling Coordinator at (919) 843-8884.

Sections

Reservation Request Form

Please notify OIS immediately of any changes or cancellations.