Reservation Request Form

Company/Organization Profile

Event Profile

Facilities Requested

Yes No
Yes No
Yes No
Yes No

Facilities Requested

Yes No
Yes No
Yes No
Yes No

Facilities Requested

Yes No
Yes No
Yes No

Facilities Requested

Yes No
Yes No
5mm/0 degree scope: 5mm/30 degree scope:
Yes No

Education Center

*Standard AV is included in each room (Projector, screen, podium with microphone, computer, internet, slide advancer, and laser pointer)

Meeting Room(s)
Auditorium
Pre-Function
Exec. Boardroom
Dining Room
Other:
Tripod Display Easels
Panel Tables
(List additional AV under AV needs)
Exhibitor Tables
Do you need electric for any of the exhibitor tables? Yes No

Virtual Patient Care

Debrief Room(s)
Team Training 1-5
Patient Lounge
Individual Training Rooms 1-8
Exam Room 1-6
Computer Training Room
Yes   No
Yes   No

Catering Needs

Breakfast
Snack/Break
Lunch
Reception
Dinner
Tables
Rectangle
Round (Additional Charge)
Linens
Black Spandex
Beige
High-top tables (w/black spandex covers)

AV Needs

Lavaliere Mic(s)
Video Feed
Wired Mics
Wireles Mics
Dedicated AV Technician

Parking Needs

Group will self-pay
Crosstown lot/Fort Brooke Garage parking vouchers requested ($10 per vehicle, depending on availability)
Group will arrive by bus
Valet service is requests (additional charge)

Logistical Needs

Travel
Hotel Reservations
Online Registration
Other

Shipping and Receiving Needs

Photography

Yes   No
Yes   No