UTA Math Dept Room Request Form

- All room requests (including PKH485 & 487) require at least ONE WEEK notice!
- Room location will be based on availability.
- Approvals take 2 to 4 days.
- Requests submitted wanting a one day turnaround are NOT possible.
- Reservations after the LAST day of classes for each semester will take longer for approval.
- Room requests times during peak class hours are not possible.
- Review sessions will need to be held later in the day in order to secure a room.

Requester's Name: Requester's Name: Title First Last Suffix
Requester's Email address:
Requester's phone number: Requester's phone number: - ### - ### ####
Requester's Organization/Group/Club Name:
Organization's Name and/or Group Adviser's Name:
Please provide a brief description of what the room is needed for: (Review, Presentation, Research, Meeting, Interview, Dissertation Defense, Comprehensive Exam, Master's Project/Defense, Seminar, Colloquium, etc.)

Provide a brief description of what the room is needed for. Please list club or organization name.
How Many Seats Needed:
Any "Must-Have" Room Requirements:

Moveable tables/chairs, smart/whiteboard, projector, audio, webcam, laser pointer, etc. If no requirements needed please enter, None.
Please list all DATES with START & END times and Number of Rooms per date Needed:

Example:

3/2/19 1pm-2pm; 2 rooms
4/4/19 2pm-3pm; 1 room
Is this request for a Dissertation Defense?

Is this request for a Dissertation Defense? Yes No
Will MathIT assistance be needed?

Would you like MathIT to show up before the meeting/event to help with any IT setup?
If MathIT assistance is needed, what would you like help with?
Any Additional Comments: