HARRELL MEDICAL EDUCATION BUILDING EVENT REQUEST DATE OF YOUR EVENT* 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* BEGIN TIME* : HH MM AM PM (INCLUDING SETUP)END TIME* : HH MM 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 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 ANYPLEASE PROVIDE ADDITIONAL INFORMATION, IF DESIRED
