Your Contact Information
Your Name*:
Email Address*:
Phone number*:

Course Information
Faculty*:
Department*:
Course Name*:
Course Code*:	(ie: AP/ABCD 1530)

Course Director's Contact Information - only if different from above
Name:
Email Address:
Phone number:

Scheduling Information
Year Required*:
Semester Required*:
Start Date for Lab Use*:
Finish Date for Lab use. (Please note: all bookings normally end on the last day of classes)*:

Regularly Scheduled Classes and Tutorials
Section	Day	Number of Seats Required	Start Time	End Time

Additional Information
*Software Required.** Type "none" if no software is required: Software titles, or "image as is", must be noted before a booking can be confirmed.* (i.e. MS-Word, SPSS, Web Browser, Moodle, Image as is, etc.)
Audio/Video Aid Needs:
Additional Information. Please provide any additional information in this field of the form: