DBEI/CCEB Room Request Form

DBEI/CCEB Room Request Form

Please view the Blockley Hall room schedule on the EMS scheduling system before requesting a room to be sure it is available at the time you submit your request. However, even though a room may appear available within the system, a pending request may already be in the queue. Please use this form for Blockley 235, 418, 505, 701, 840, and 940.

511 & 824 are scheduled through an Outlook Resource calendar and are not on the EMS scheduling system. 511 is currently for the exclusive use of CRCU.

Please submit request with a minimum of one week's notice. We cannot guarantee that requests submitted without sufficient notice will be confirmed. Please do not assume a request submitted is confirmed until you receive the confirmation with reference number.

If you are not going to use a room, please be sure to send notice of cancellation with reference number to ccebconf@pennmedicine.upenn.edu as soon as possible.

Name Name First Last
Contact person for this request
Email
Department /Center / Institute
Division / Affiliation

Division / Affiliation Biomedical Graduate Studies (GGEB) Biostatistics Biostatistics and Epidemiology (Business Office) CCEB Epidemiology Informatics Office of the Chair
Office Phone Number

The NEW scheduling system requires email and phone for requester.
Meeting Name (USE ALL CAPS):

USE ALL CAPS and please be as detailed as possible (Example: Yellow Study meeting - Dr. Smith)
Meeting Date(s):

If reccurring, please enter the days needed
(Example: Monday 9/27 & Friday 10/1, every Wednesday 4/10, 4/17, 4/24, etc.)
Please select day(s) of the week

Please select day(s) of the week Monday Tuesday Wednesday Thursday Friday
Start Time Start Time : HH MM AM/PM
End Time End Time : HH MM AM/PM
Estimated Number of Attendees
Room Location (1st Choice)
Room Location (2nd Choice)
For Strom Conference Room (BLK 701) ONLY: Preferred Set-Up

A change in set-up requires at least 30 minutes between events. Please do not rearrange 701.
Will there be catered food?

Will there be catered food? Yes No
Comments

Optional
Please provide details on special requests, catering information, etc.
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