Room Reservation Request Form

This form is for History Faculty and History Graduate Students Only

Please fill out all of the highlighted fields. When you click "Submit" at the bottom of the page your request will be sent to the electronic workbox. Unless you see "Thank you for submitting your form," your form has not successfully been submitted. When your room has been reserved, you will receive email confirmation.

Please allow a minimum of three working days.

NAME:

DATE NEEDED:

TIME NEEDED:

DURATION YOU WILL NEED THE ROOM:

COURSE NUMBER:

PURPOSE FOR ROOM:

HOW MANY PEOPLE DO YOU NEED TO ACCOMODATE:

Specific room & bldg. your interested in: 1st Choice:

2nd Choice:

Confirmation will be made by email; your email address:

**If event is cancelled I understand that it is my responsibility to inform staff via email to hist-workbox@ad.uiuc.edu.
Yes: (initial)

If special equipment is needed, please fill out the A/V Equipment Request form
If event is to be entered on the History Dept. Web Calendar, the following information must be filled out.

Event short title:

Event title:

Display on History Dept. Web Calendar:
Yes or No

Event type: Colloquium Confernce Lecture Meeting/Panel Discussion Symposiums Job Talk

Contact's name

Contact's email

Contact's phone

Events listed on the History Dept. Calendar are at the discretion of the Chair.

revised 2006.10.31

Please make sure you have filled out all of the fields. Remember, unless you see "Thank you for submitting your form," your form has not successfully been submitted.