*Last Name:  

*First Name: 

*Company Name: 

*Address: 

*City: 

State: 

*Zip: 

*Phone: 

*email: 

*Meeting Name : 

Example: 'Teaching Strategies for New English Learners'

*Meeting Date :  

*Meeting Time :   

Number of hours room will be needed : 

*Which conference room do you wish to reserve? (Please check one.)
Conference Room A
Conference Room B
Conference Rooms A & B
Classroom

Number of attendees: 

Please select all of the audio/visual equipment required for your meeting.
 Overhead projector
 DVD Player
 Flip chart

*Do you need catering services for your meeting?
Yes
No

Additional requests or comments:

Fields preceded by an asterisk are required.

NOTE: A cancellation fee of 50.00 per room will be charged if cancelled less than five (5) business days before event.