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Space Request Form

This is a request, only. You will be contacted to complete the scheduling of this event. Thank you.

In order to use the UW Extension Conference Centers, the event must be an official function of a University of Wisconsin System department; or a State of Wisconsin/Federal government department. If you are unsure as to whether you can use our services, please see our Policies or contact us.

Fields marked with an * are required.

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Events Calendar

UW or Government Department:
Conference Center Preferred:
Estimated Attendance:
Event Date(s) & Day(s): (Example: Thursday, July 4, 2009)
Event Title:
Event Meeting Times Each Day:
Meeting Spaces Preferred (Room Number, Type):
Note: Specific room numbers may be requested but are tentative -- ECC staff reserves the right to change location of your meeting rooms, lounges, and dining area to meet daily operational requirements.

Conference	Computer Lab
Committee Meeting	Audioconference More info
Lecture	Videoconference More info
Breakfast	Webconference More info
Luncheon	Webcast More info
Reception	Other If other, please specify:
Dinner/Banquet	Other If other, please specify:
Guest Rooms Guest rooms at the:	The Lowell Center
Number of Guest Rooms Needed:
Arrival Date:
Departure Date:

	Workshop/Classroom See setup
	Herringbone (working groups) See setup
	Lecture (chairs only) See setup
	Hollow Square See setup
	Solid Square (Board Table)
	U Shape See setup
	Do not know
	Other Please specify:

*Name:
*Department/Company/Organization:
*Address 1:
Address 2:
*City, State, Zip:
*Phone:
FAX:
*Email:
How did you hear about us? Please check all that apply:	Conferencing Web Site Other Web Site Previous Event Print Ad Referral Other If other, please specify:
Please check if you would like a tour of our Centers:
Additional Comments:
Please enter the correct answer to help prevent spam: What's This? 7 + 5 = * Anti-Spam Field: We want to hear from you, but like so many other web sites, our web forms are being flooded with unwanted spam. Providing an answer to some simple arithmetic should be easy for a person to do, but it's pretty tough for the computer generated spam to fathom. So please let us know if you have any questions, comments, or suggestions for our web site... but if you don't do the math, we won't get the message! Thank you.

Space Request Form

Event Information

Event Type

Room Setup

Catering Needs

Audiovisual Needs

Parking Needs

Requester/Customer Information

Yes No Do not know
If yes, please specify:
More information about Catering Services.

Yes No Do not know
If yes, please specify: Special items needed:
More information about Audiovisual Services.