HARRELL MEDICAL EDUCATION BUILDING EVENT REQUEST DATE OF YOUR EVENT* MM slash DD slash YYYY NAME OF PROPOSED ACTIVITY* TYPE OF ACTIVITY*MeetingClassConferenceExamInterviewOrientationPresentationReceptionTrainingWorkshopOther – Please explain in space provided belowSPONSORING (BILLING) DEPARTMENT/COLLEGE* INITIATOR/EVENT FACILITATOR* First Last INITIATOR/FACILITATOR E-MAIL* INITIATOR/EVENT FACILITATOR TELEPHONE*DATE AND TIME OF PROPOSED ACTIVITYDATE* MM slash DD slash YYYY BEGIN TIME* : Hours Minutes AM PM AM/PM (INCLUDING SETUP)END TIME* : Hours Minutes AM PM AM/PM (INCLUDING CLEANUP)APPROXIMATE NUMBER OF PARTICIPANTS*WILL FOOD BE SERVED?* YES NO If YES, a work order will need to be placed with UF Facility Services (FS) for custodial coverage (352-392-1121) and will require a separate fee paid to FS. If your event is during buisness hours (8a-5p MON-FRI), you do not need to arrange Custodial Coverage but you as the Renter will be responsible for taking the trash to dumpster (located outside on NW corner of the building / shared with HPNP) and for general cleanup following your event. WILL THE CATERING KITCHEN BE USED?* YES NO Room ReservationsYou must reserve you room via EMS system: https://education.med.ufl.edu/hmeb/)Have you Reserved your room on EMS? Yes No FOR SCOTT COMMONS RESERVATIONS, WILL FURNITURE BE MOVED?* YES NO If YES, a work order will need to be placed with UF Facility Services (352-392- 1121) and will require a separate fee paid to PPD. FURNITURE MAY NOT BE MOVED BY CATERERS OR EVENT FACILITATORS. PLEASE INDICATE SPECIFIC ROOM PREFERENCE, IF ANY PLEASE PROVIDE ADDITIONAL INFORMATION, IF DESIRED
