Request Date

Clarion University

Learning and Technology Center Lab
Reservation Form

NOTE: Form is not currently active.

Please contact the LTC directly (dausel@clarion.edu) to check lab availability.

Complete and print this form to request the use of the Learning and Technology Center in 103 Still Hall. It is only available to university-affiliated groups. There is a charge for lab use by fee-based or grant-funded workshops. The LTC will have priority in scheduling the lab.

Submit printed form to Darla Ausel, Computing Services, 101 Still Hall.

Name	(First) (Last)
Department	Phone
Email Address
There must be a university-affiliated employee supervising the lab during the event if it is held during off hours. If requester is not the presenter, please provide the following information:
Presenter 1 Name & Organization	(Name) (Org)
Presenter 2 Name & Organization	(Name) (Org)
Checked Availability?	Yes No
Date Requested
Time Requested	to Please include time for setup for your presentation.
Describe Purpose of Lab Use (Be specific. Identify software, users, etc.) No. of Participants Expected?
I will NOT be installing special software. I WILL be installing special software and have made arrangements with Computing Services authorized vendor. (You must identify the software you will be installing in the box below.) I understand that this software must be properly licensed and that it will be uninstalled after the workshop is completed. I will complete the software installation reservation form for a time to install and uninstall software. Software to be installed includes: Workshop Type: Fee-Based Grant-Funded Non-Fee Based If fee-based or grant-funded, enter your cost center number to cover the lab fee.

I have read and agree to the terms of the LTC Lab Use Checklist and am university affiliated

LTC Lab Home

For assistance on the smart classroom, please contact Darla Ausel, Learning & Technology Center, 814-393-1848.
1/20/2012