Event Information
Workshop title*:
Number of Attendees Expected*:
Date of Workshop (i.e. Friday March 19/10)*
Start time*:
End time*:
Associated Course Code (or attendee affiliation):
Is this a cost recovery event? (do attendees pay to attend):

Event Leader Information
Full Name*:
YorkU userID*:
Email Address*:
Phone number*:
Faculty/Department Affiliation*:

York U Contact Information (for ticket tracking) - only required if different from event/workshop leader
Full Name:
Email Address:
Phone number:
Faculty/Department Affiliation:

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, Web Browser, SPSS, Moodle, Image as is, etc.)
Audio/Video Aid Needs:
Additional Information . Please provide any additional information in this field of the form*: