InCHIP Room Reservation Request Form InCHIP Room Reservation Request Form The information below is required to request InCHIP meeting space for a one-time event or meeting. If you want to reserve space for a recurring meeting, please scroll to the appropriate form. Please note that course-related meetings are not permitted. Please fill out the following form. Once your request is reviewed, you will be contacted by an InCHIP administrative staff member. Name* First Last Email* Best number to reach you.*Preferred method of contact.*EmailPhoneWhat is your association with InCHIP?*Employee/Staff/StudentInCHIP AffiliateN/ADepartment/Center/Institute/School*Please tell us about yourself:*FacultyStaffResearch ScientistResearch Associate/AssistantGraduate StudentUndergraduate StudentOtherPlease describe your position:*Please provide details about the event (presentation, workshop, etc.)*Requested meeting date:* Date Format: MM slash DD slash YYYY Start time:* : HH MM AM PM End time:* : HH MM AM PM Anticipated number of in-person attendees?*Anticipated number of remote attendees?*Please note that we require 14 Days Notice for IT Support. Please indicate if you need any of the following:* Remote Participation (Webex) Recording Capabilities Polycom Conference Phone None Will food be served?* Yes No Please allow yourself time for set-up and clean-up. *If you are using InCHIP funds, fill out a business meal form.NameThis field is for validation purposes and should be left unchanged.