Academic Event Scheduling Request Form :: University of Pennsylvania Central Pool Classrooms

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Academic Event Scheduling Form for Central Pool Classrooms

Use this form to request central pool classrooms for short-term academic events, such as: mid-term exams, review sessions, special lectures, or departmental meetings.

DO NOT COMPLETE THIS FORM IF:

food and/or beverages will be served at this event
this event will be held on a Saturday or Sunday
this event includes a high-profile speaker
this event includes a performance of any kind
special audio-visual setups are required at this event

Special audio visual setups are defined as any request for equipment or configuration that is not part of the standard technology setup in the room, such as:

voice amplification in rooms without that capability

multiple, panel, or audience microphones

dedicated technical support required throughout the event

Information about the standard technology setup for any central pool classroom can be found in the Classroom Finder.
If any of the above conditions apply, please complete the Special Event Reservation Form.

BOOKINGS ARE MADE PER THE START AND END TIMES PROVIDED.

If you require extra time after an event, include that in your "end time". For example, if you need an additional 15 minutes after a 12:00 noon - 2:00 PM exam, the requested times should be from 12:00 noon to 2:15 PM.

*** All fields in RED must be filled out completely. Incomplete forms will not be accepted.

Step 1 - Please provide information about yourself:

	i.e., School/Center/Department
Name:
Telephone Number:
Full Email Address:
Affiliation:

Step 2 - If the event is related in any way to a course, you must indicate the subject and course/section numbers below (e.g., ECON 002-401). All courses at Penn have both course and section numbers.

Subject Code (e.g., ECON)	Course Number		Section Number
		-

Step 3 - Please provide information about your course or event:

Required Seating Capacity:

Occurs:

	One Time Event		Occurs Weekly

On Day(s) of the Week:

	Monday		Tuesday		Wednesday
	Thursday		Friday

Start Date:

End Date:
(for weekly events)

Start Time:

End Time:

Purpose of Event:
(e.g., example: midterm,
review session)

Step 4 - Please indicate your audio-visual equipment needs:

	computer w/ Windows
	Macintosh computer
	laptop computer input

	DVD player
	multi-region DVD player

	video and computer projection
	portable AV projection

	overhead projector
	document camera

	CD player
	record player

	Sympodium

	large display monitor

	wireless microphone
	podium microphone
	additional microphone inputs

	VCR
	multi-standard VCR

	projection screen
	dual projection screens

	single 35mm slide projector
	dual 35mm slide projector

	single deck cassette player
	dual deck cassette player

	power at student seats

	LaserDisc player

Other audio-visual equipment:

Step 5 - Please provide information about your location preferences:

First choice:
Second choice:
Third choice:

Step 6 - Please enter any additional comments below:

Other Request Forms:
Academic Course Room Change
Special Event Scheduling



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