UVI Facilities Request Form

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Telephone Number
Sponsoring Department or Agency
Mailing Address:
Email Address:
Request:
Space Requested
Date(s)
Time
Indicate Desired Room
Video Conference Rooms
Smart Classrooms
Labs
Number of Expected Participants    
Type of Activity: (i.e. Guest Speaker, etc.)
Additional information, promotional material on activity
Special Arrangements:
Equipment:
Media Services:
Fee for use of facilities:
Damage/Cleaning Deposit
Total:
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