Contact Name:
Department:
Email:
Phone:

Term: Fall 2009 Winter 2010 Spring 2010
Course ID:

Meeting Description:
Expected Number of People:


Days (e.g. MTWRFSU):

Start Date:
End Date:
Start Time: (include set up time)
End Time: (include tear down time)

Location Preferences (Optional)
   First Choice:
   Second Choice:
   Third Choice:

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Additional Information: (Please specify additional information here.)