TEMPLE UNIVERSITY AMBLER
TECHNOLOGY CLASSROOM REQUEST FORM
(Smart Classroom/Computer Classroom)

INSTRUCTOR INFORMATION

First Name:   Last Name:   Department:

Office Phone:   Home Phone:   E-mail address:


COURSE INFORMATION

Department: Course Number:   Section Number:   Course Title:

Semester:   Year:   Days: Monday  Tuesday  Wednesday  Thursday  Friday  Saturday  Sunday

Starting Time:   Ending Time:   Course Reference Number:   Number of seats authorized:


CLASSROOM NEEDED

Smart Classroom         Building Preference:

Computer Classroom (Lab)*

* If you are requesting a Computer Classroom please specify the type of computer you require. 

 

EQUIPMENT USE

Will you need the classroom for every class meeting or for specific dates?
If you will be requesting the classroom for specific dates, please indicate those dates below.

Every Class              Specific Dates     Please list dates:

Please select any other equipment you will need in the room you are requesting.