Stanley J. Lucas Board Room

Henry R. Winkler Center for the History of the Health Professions

University of Cincinnati Libraries

Application for Room Use

(please print)

Date of application:_________________

User Name :_______________________________________Department/ML_____________________________

Phone # _____________________________   Alternative phone # (Home or cell) _______________________

Date(s) requested____________________________     Time(s):________________________

Number of Attendees:______________________

Function: ___________________________________________________________________________________

Will the use of the hallway in front of Winkler Center (E099) be required?  _____ ( If so, the user is responsible for reserving the space)

Will food be served ?:________________________________________________________________________

Catered:________  Box lunch:________  Notes:   _____________________________________________________________________________

Equipment required:  _________________________________________________________________________

(The user is responsible for making all equipment arrangements beyond those present in the room.  The user is also responsible for making sure that

they know how to use the equipment in the room. It is suggested that they arrange for instruction in advance of the meeting.)

Furniture arrangement required: ________________________________________________________________

RESPONSIBILITIES OF USER:

                  - Do not alter the room arrangement

                  - Remove all food and food garbage

                  - Provide general clean-up with ½ hour of end of session

                  - If required, the user is responsible for reserving the space outside of the Winkler Center and ordering tables for catering and registration

                  -

Please read Lucas Room Usage Guidelines  for other responsibilities, equipment available,  and other information.

Contact:  (signature and date)  _____________________

 Department or Project Head (signature and date) __________________________________

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For Office use only:      Scheduled by :  ____________   Date: _____________ 

Notes:___________________________________________________________________________________

_________________________________________________________________________________________

10/20/08 ; rev 2/4/10; rev 3/16/10  DAH