Staff Room Booking Form

Step 1 of 5

Contact Details

Name(Required)

First Last

Email(Required)

Phone Number / Extension(Required)

Area / Department(Required)

ex. ADA Office

Type of Request(Required)

Type of Course-Related Request(Required)

Booking Details - Course Related - Guest Speaker

Booking Details - Course Related - Other

Booking Details - Course Related - Breakout Room Session

Booking Details - Course Related - Make-Up Class/Exam

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Booking Details - Course Related

Booking Title(Required)

Type of Makeup Session(Required)

Reason for Request

ex. deferred exam; inclement weather; illness

Session (Term)(Required)

Choose the applicable term.

Start Date(Required)

Start Time(Required)

End Date(Required)

End Time(Required)

Building Preference(Required)

Room Type(Required)

Number of Participants(Required)

Capacity Per Room(Required)

Number of Participants(Required)

Capacity of Room(Required)

Quantity of Rooms Requested(Required)

Preferred Rooms

File Upload

To request multiple dates and/or times, upload an excel spreadsheet with the additional requests via the File Upload option.

Accepted file types: xlsx, xls, doc, docx, Max. file size: 50 MB.

I hereby confirm by checking the appropriate boxes below that I have (the instructor has) done the following:(Required)

Attempted to find another instructor to teaching the class / administer the exam.

I / the instructor will inform and provide to students all necessary accommodations if they are not able to attend the makeup session

Additional Comments

Contact Details

Course Details

Permanent Classroom Change