________________

Date Received Denied

Approved

BPDTC

RESERVATIONS REQUEST

Rosa Roman

Buffalo Professional Development & Technology Center

Curriculum/Staff Development

150 Lower Terrace

816-3048 Ext 8764

Please fill out required fields:

Name: ______________________________________________

Department: ______________________________________________

Phone/Fax: ______________________________________________

Purpose: ______________________________________________

# of Participants: ______________________________________________

Date of Event: ______________________________________________

Time of Event: ______________________________________________

Audio Equipment: ______________________________________________

Signature: ______________________________________________

Circle Room: 453 A & 453 B 419 424

(Conf. Rooms) (MAC Lab) (MAC/PC Lab)

PLEASE NOTE THE FOLLOWING:

Rooms 453 A & B holds up to 40 persons

Rooms 419 and 424 holds up to 21 persons

NO MEETING OR IN-SERVICE TO BE SCHEDULED BEFORE 8:30 AM

YOU ARE RESPONSIBLE FOR CLEAN UP AFTER MEETING

FAX 851-3062