Building 3 Conference Room 505 Request Form

Please review the Division of Experimental Medicine (DEM) conference room website for detailed room information: https://experimentalmedicine.ucsf.edu/about/conference-room-services Please also review the viewable conference room calendar on Outlook under "DOM – ZSFG Bldg 3 505 Conference Room." The conference room is located at: UCSF at Zuckerberg San Francisco General 1001 Potrero Avenue, Building 3, Room 505, San Francisco, CA 94110

Today's Date

Please provide today's date below.

mm/dd/yyyy

Event primary contact first name

Event primary contact last name

Phone number

Lab Group

Name of event

Date of event

Recurring Date List

If you have a recurring event please list the subsequent dates that have the same event details (set-up, number of participants, time, etc.). If an event is apart of this series and requires a different time, please submit a new form.

Set Up Time

Start of your access to the event space. (XX:XX AM or PM)

Start Time

Beginning of your event. (XX:XX AM or PM)

End Time

End of access to the event space. (XX:XX AM or PM)

Special requests

Zoom, projector/screen set-up, whiteboard access, podium, OWL

Number of anticipated guests

Does your event have food?

Yes

COA, SpeedType, or Cost Center Number

I acknowledge that I have reviewed the Experimental Medicine conference room website (https://experimentalmedicine.ucsf.edu/about/conference-room-services) and agree to abide by the policies and expectations associated with the use of this room.

Send me a copy of my responses

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