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Greenblatt Library Services and Programs

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Suggestion Box

Room Request Form


Date of event:	(required)
Start Time:	(required)
End Time:	(required)
Number of Students / Users expected:	(required)
Reason for request; list class name if appropriate. (required)

Requestor Name:
Requestor Email:	(required)
Requestor Barcode:
Requestor Phone No.
Requestor Department:
Requestor School:


Room Information Required
Electronic Classroom:	149 (seat 9) 163 (seat 19) 127 (seat 30) Note: By requesting use of an electronic classroom you agree to abide by and be responsible for enforcing the Guidelines for Use of Electronic Classrooms.


Conference Room:	211 (seat 24) 224 (seat 15)


Group Study Room:	132 (seat 2) 133 (seat 2) 134 (seat 2) 135 (seat 2) 139 (seat 6)


Other Locations:	On-campus Location Off-campus Location Other (specify)

Greenblatt Room:	Note: By requesting use of the Greenblatt room you agree to abide by and be responsible for enforcing the Guidelines for Use of Greenblatt Conference Room.

Instructor Name:

Instructor Barcode:

Special notes or equipment requirements:

Please email comments, suggestions or questions to: mtruitt@mcg.edu

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Copyright 2005, Medical College of Georgia, All rights reserved.
September 08, 2005