University of Vermont

College of Arts and Sciences

Department of Psychological Science

Psychological Science Department

Room Request Form

NOTE: You will need to save the form to your computer

and then send as an attachment to

Today’s Date:

(Month/Date, i.e. 6/2 )

Person Reserving:

(if you are reserving on behalf of someone, please include that person’s name)


(if for a course, please list course name and number.. i.e. Abnormal #130)

Number Expected:

Start Date and Time:

End Date and Time:

One Time Use:

Repeating Request Parameters:

(Please list by Semester only)

Rooms Available in Dewey:

Room 100 – Lecture/conference room (seats up to 30) Room 126 – Biobehavioral lab

Room 128 – Computer lab Room 238 – Lecture/conference room (seats up to 15)

Room 342 – Lecture/conference room (seats up to 12)

Request for a Lecture Hall in Dewey:

Room 212 (seats up to 30) Room 314 (seats up to 70)

Request for Room outside of Dewey:

If specific building/room needed:

Comments/Additional Information to assist in completing this reservation

dms 6/2014

Last modified June 27 2014 11:58 AM

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