Facilities Request Form

Transcription

Facilities Request Form
The William H. Miner Agricultural Research Institute
1034 Miner Farm Road
PO Box 90
Chazy, NY 12921
Print Form
Current Date
www.whminer.org
Submit by Email
2014-12-24 09:17:41
New Request
Revised Request
Facilities Request Form
Please complete the form below to request a reservation.
Visitor / Name of Event: Yankee Farm Credit and Farm Credit East Producer meeting
Amy
Contact Information:
Submitted by:
Ext: 117
[email protected]
Events Begins: Date Wednesday, January 14, 2015
Time 11:00
a.m.
Events Ends: Date
Time 2:00
p.m.
Wednesday, January 14, 2015
Facilities Required
(List all that apply)
TBA
Phone Number: 802-734-4973
Email Address:
Wanda
Number Attending:
Miner Center Auditorium
Other Accomodations or Requests
updates will be coming next week
See additional comments on back
Send Copies to:
Check all services that you will need:
Katie Ballard, Director of Research
Housekeeping
Kirk Beattie, Finance & Personnel Officer
Amy Bedard, Library
Cafeteria
After Hours
Coverage
Custodial Service
Bill the following services to:
Charge services to:
Steve Couture, Dairy Farm Manager
Wanda Emerich, Outreach Coordinator
Steve Fessette, Director of Physical Plant
Name
Amy, Yankee Farm Credit
Address
Rick Grant, President
Steve Kramer, Director of Laboratories
City
ST
Rachel Dutil, Administrative Assistant
Karen Lassell, Equine Manager
Zip
Time
Morning
Break
$1.50 - Beverages only
11:00
> 20 - See Kirk for pricing
noon
Quantity
Laurie Miller, Accounting / Payroll
Cafeteria
Housekeeping
Lunch
Afternoon
Break
Miner Center Custodial
Other
Dinner
GRAND TOTAL
Total
Miner Institute - Chazy NY
Facilities Request Form
Page 2
Room Configuration
Traditional Speaker/Audience
Audio/Visual Equipment
Please check audio/visual equipment you will
need for your event (check all that apply):
Chalkboard
Digital Projection System
Tables in U Shape (18 maximum)
Dry Erase Board & markers
Easel, flipchart, & markers
Laser pointer
Overhead Projector
PA System
Slide Projector
Surge Protected Electrical Outlet Strip
Extra long phone cord
Television
VCR
Other
Tables in Two Rows (20 maximum)
Additional Comments
Tables in Rectangle (24 maximum)
Tables in Modified U Shape (36 maximum)
Chairs in a V-shape
The William H. Miner Agricultural Research Institute
1034 Miner Farm Road
PO Box 90
Chazy, NY 12921
Print Form
Current Date
www.whminer.org
Submit by Email
2014-07-10 12:26:52
New Request
Revised Request
Facilities Request Form
Please complete the form below to request a reservation.
Visitor / Name of Event: CCE NNYDI Repro Program
Kim Morrill
Contact Information:
Submitted by:
Number Attending:
Phone Number: (603)-568-1404
Email Address:
Wanda
Ext: 117
[email protected]
Events Begins: Date Thursday, January 15, 2015
Time 10:00
a.m.
Events Ends: Date
Time 3:00
p.m.
Thursday, January 15, 2015
Facilities Required
(List all that apply)
15-20
Miner Center Auditorium
Other Accomodations or Requests
See additional comments on back
Send Copies to:
Check all services that you will need:
Katie Ballard, Director of Research
Housekeeping
Kirk Beattie, Finance & Personnel Officer
Amy Bedard, Library
Cafeteria
After Hours
Coverage
Custodial Service
Bill the following services to:
Charge services to:
Steve Couture, Dairy Farm Manager
Wanda Emerich, Outreach Coordinator
Steve Fessette, Director of Physical Plant
Name
Address
Rick Grant, President
Steve Kramer, Director of Laboratories
City
ST
Rachel Dutil, Administrative Assistant
Karen Lassell, Equine Manager
Zip
Time
Morning
Break
Quantity
Total
$2.50 - Snacks & beverages
10:00 AM
20
$50
$5.50 - Institute Lunch - < 20
noon
20
$110
Laurie Miller, Accounting / Payroll
Lunch
Cafeteria
Housekeeping
Afternoon
Break
Miner Center Custodial
Other
Dinner
AESP faculty
GRAND TOTAL
Miner Institute - Chazy NY
Facilities Request Form
Page 2
Room Configuration
Traditional Speaker/Audience
Audio/Visual Equipment
Please check audio/visual equipment you will
need for your event (check all that apply):
Chalkboard
Digital Projection System
Tables in U Shape (18 maximum)
Dry Erase Board & markers
Easel, flipchart, & markers
Laser pointer
Overhead Projector
PA System
Slide Projector
Surge Protected Electrical Outlet Strip
Extra long phone cord
Television
VCR
Other
Tables in Two Rows (20 maximum)
Additional Comments
Tables in Rectangle (24 maximum)
Tables in Modified U Shape (36 maximum)
Chairs in a V-shape
The William H. Miner Agricultural Research Institute
1034 Miner Farm Road
PO Box 90
Chazy, NY 12921
Print Form
Current Date
www.whminer.org
Submit by Email
2015-01-05 09:39:30
New Request
Revised Request
Facilities Request Form
Please complete the form below to request a reservation.
Visitor / Name of Event: The Burkes
Number Attending:
Contact Information:
Submitted by:
Phone Number:
Rachel
Email Address:
[email protected]
Events Begins: Date Thursday, January 29, 2015
Events Ends: Date
2
Sunday, February 1, 2015
Facilities Required
(List all that apply)
Ext: 115
Time
p.m.
Time
p.m.
Shadow Lawn Guest House
Other Accomodations or Requests
the usual please
See additional comments on back
Send Copies to:
Check all services that you will need:
Katie Ballard, Director of Research
Housekeeping
Kirk Beattie, Finance & Personnel Officer
Amy Bedard, Library
Cafeteria
After Hours
Coverage
Custodial Service
Bill the following services to:
Charge services to:
Steve Couture, Dairy Farm Manager
Wanda Emerich, Outreach Coordinator
Steve Fessette, Director of Physical Plant
Name
Address
Rick Grant, President
Steve Kramer, Director of Laboratories
City
ST
Rachel Dutil, Administrative Assistant
Karen Lassell, Equine Manager
Zip
Time
Quantity
Morning
Break
Laurie Miller, Accounting / Payroll
Cafeteria
Housekeeping
Lunch
Afternoon
Break
Miner Center Custodial
Other
Dinner
GRAND TOTAL
Total
The William H. Miner Agricultural Research Institute
1034 Miner Farm Road
PO Box 90
Chazy, NY 12921
Print Form
Current Date
www.whminer.org
Submit by Email
2014-09-23 09:25:18
New Request
Revised Request
Facilities Request Form
Please complete the form below to request a reservation.
Visitor / Name of Event: Cornell Maple School
Mike Farrell
Contact Information:
Submitted by:
Number Attending:
Phone Number: O: 523-9337 C: 637 7000
Email Address:
Wanda
Ext:
[email protected]
Events Begins: Date Friday, January 30, 2015
Time 3:30
p.m.
Friday, January 30, 2015
Time 8:30
p.m.
Events Ends: Date
Facilities Required
(List all that apply)
TBA
Miner Center Auditorium
Other Accomodations or Requests
details to follow later
See additional comments on back
Send Copies to:
Check all services that you will need:
Katie Ballard, Director of Research
Housekeeping
Kirk Beattie, Finance & Personnel Officer
Amy Bedard, Library
Cafeteria
After Hours
Coverage
Custodial Service
Bill the following services to:
Charge services to:
Steve Couture, Dairy Farm Manager
Wanda Emerich, Outreach Coordinator
Steve Fessette, Director of Physical Plant
Name
The Uihlein Forest Cornell University Departme
Address
157 Bear Cub Lane
City
Lake Placid
Rick Grant, President
Steve Kramer, Director of Laboratories
Rachel Dutil, Administrative Assistant
Karen Lassell, Equine Manager
ST NY
Zip 12946
Time
Quantity
Morning
Break
Laurie Miller, Accounting / Payroll
Cafeteria
Housekeeping
Lunch
Afternoon
Break
Miner Center Custodial
Other
Dinner
GRAND TOTAL
Total
Miner Institute - Chazy NY
Facilities Request Form
Page 2
Room Configuration
Traditional Speaker/Audience
Audio/Visual Equipment
Please check audio/visual equipment you will
need for your event (check all that apply):
Chalkboard
Digital Projection System
Tables in U Shape (18 maximum)
Dry Erase Board & markers
Easel, flipchart, & markers
Laser pointer
Overhead Projector
PA System
Slide Projector
Surge Protected Electrical Outlet Strip
Extra long phone cord
Television
VCR
Other
Tables in Two Rows (20 maximum)
Additional Comments
Tables in Rectangle (24 maximum)
Tables in Modified U Shape (36 maximum)
Chairs in a V-shape
The William H. Miner Agricultural Research Institute
1034 Miner Farm Road
PO Box 90
Chazy, NY 12921
Print Form
Current Date
www.whminer.org
Submit by Email
2014-09-23 10:19:15
New Request
Revised Request
Facilities Request Form
Please complete the form below to request a reservation.
Visitor / Name of Event: 4H Horse Bowl and Hippology
Karen
Contact Information:
Submitted by:
Number Attending:
Rachel
Phone Number: ext. 120
Email Address:
[email protected]
Ext: 115
Events Begins: Date Saturday, February 7, 2015
Time 7
a.m.
Saturday, February 7, 2015
Time 7
p.m.
Events Ends: Date
Facilities Required
(List all that apply)
Miner Center Auditorium
Other Accomodations or Requests
~100
board room; green room
cafeteria annex; computer lab
Cafeteria will be used for lunch; tech office for 4H personnel; library for kid activities in the
morning. Please have tables along wall of auditorium and garbages please!
See additional comments on back
Send Copies to:
Check all services that you will need:
Katie Ballard, Director of Research
Housekeeping
Kirk Beattie, Finance & Personnel Officer
Amy Bedard, Library
Cafeteria
After Hours
Coverage
Custodial Service
Bill the following services to:
Charge services to:
Steve Couture, Dairy Farm Manager
Wanda Emerich, Outreach Coordinator
Steve Fessette, Director of Physical Plant
Name
Address
Rick Grant, President
Steve Kramer, Director of Laboratories
City
ST
Rachel Dutil, Administrative Assistant
Karen Lassell, Equine Manager
Zip
Time
Quantity
Morning
Break
Laurie Miller, Accounting / Payroll
Cafeteria
Housekeeping
Lunch
Afternoon
Break
Miner Center Custodial
Other
Dinner
GRAND TOTAL
Total
Miner Institute - Chazy NY
Facilities Request Form
Page 2
Room Configuration
Traditional Speaker/Audience
Audio/Visual Equipment
Please check audio/visual equipment you will
need for your event (check all that apply):
Chalkboard
Digital Projection System
Tables in U Shape (18 maximum)
Dry Erase Board & markers
Easel, flipchart, & markers
Laser pointer
Overhead Projector
PA System
Slide Projector
Surge Protected Electrical Outlet Strip
Extra long phone cord
Television
VCR
Other
Tables in Two Rows (20 maximum)
Additional Comments
Tables in Rectangle (24 maximum)
Tables in Modified U Shape (36 maximum)
Chairs in a V-shape
The William H. Miner Agricultural Research Institute
1034 Miner Farm Road
PO Box 90
Chazy, NY 12921
Print Form
Current Date
www.whminer.org
Submit by Email
2014-12-16 09:19:44
New Request
Revised Request
Facilities Request Form
Please complete the form below to request a reservation.
Visitor / Name of Event: CCE Regional Calf Management Program Group
Kim Morrill
Contact Information:
Submitted by:
Number Attending:
Phone Number: (603)-568-1404
Email Address:
Wanda
Ext:
[email protected]
Events Begins: Date Thursday, February 12, 2015
Time 10:00
a.m.
Events Ends: Date
Time 3:00
p.m.
Thursday, February 12, 2015
Facilities Required
(List all that apply)
10
Miner Center Auditorium
Other Accomodations or Requests
Will need internet access for WebEx
See additional comments on back
Send Copies to:
Check all services that you will need:
Katie Ballard, Director of Research
Housekeeping
Kirk Beattie, Finance & Personnel Officer
Amy Bedard, Library
Cafeteria
After Hours
Coverage
Custodial Service
Bill the following services to:
Charge services to:
Steve Couture, Dairy Farm Manager
Wanda Emerich, Outreach Coordinator
Steve Fessette, Director of Physical Plant
Name
Kim Morrill, CCE Regional Dairy Specialist
send bill to e-mail above
Address
Rick Grant, President
Steve Kramer, Director of Laboratories
City
ST
Rachel Dutil, Administrative Assistant
Karen Lassell, Equine Manager
Zip
Time
Morning
Break
Quantity
Total
$2.50 - Snacks & beverages
10:00 AM
10
$25.00
$5.50 - Institute Lunch - < 20
noon
10
$55.00
Laurie Miller, Accounting / Payroll
Cafeteria
Housekeeping
Lunch
Afternoon
Break
Miner Center Custodial
Other
Dinner
GRAND TOTAL
Miner Institute - Chazy NY
Facilities Request Form
Page 2
Room Configuration
Traditional Speaker/Audience
Audio/Visual Equipment
Please check audio/visual equipment you will
need for your event (check all that apply):
Chalkboard
Digital Projection System
Tables in U Shape (18 maximum)
Dry Erase Board & markers
Easel, flipchart, & markers
Laser pointer
Overhead Projector
PA System
Slide Projector
Surge Protected Electrical Outlet Strip
Extra long phone cord
Television
VCR
Other
Tables in Two Rows (20 maximum)
Additional Comments
Tables in Rectangle (24 maximum)
Tables in Modified U Shape (36 maximum)
Chairs in a V-shape
The William H. Miner Agricultural Research Institute
1034 Miner Farm Road
PO Box 90
Chazy, NY 12921
Print Form
Current Date
www.whminer.org
Submit by Email
2015-01-06 11:40:16
New Request
Revised Request
Facilities Request Form
Please complete the form below to request a reservation.
Visitor / Name of Event: Institute and Museum audits
Kirk Beattie
Contact Information:
Submitted by:
Number Attending:
Rachel
Phone Number: ext. 114
Email Address:
[email protected]
Events Begins: Date Tuesday, February 17, 2015
Events Ends: Date
Thursday, February 19, 2015
Facilities Required
(List all that apply)
Ext: 115
Time
a.m.
Time
p.m.
farm office conference room
Other Accomodations or Requests
the one or two auditors will likely have lunch in the cafeteria with Kirk and Laurie Feb. 17, 18,
and 19.
See additional comments on back
Send Copies to:
Check all services that you will need:
Katie Ballard, Director of Research
Housekeeping
Kirk Beattie, Finance & Personnel Officer
Amy Bedard, Library
Cafeteria
After Hours
Coverage
Custodial Service
Bill the following services to:
Charge services to:
Steve Couture, Dairy Farm Manager
Wanda Emerich, Outreach Coordinator
Steve Fessette, Director of Physical Plant
Name
Address
Rick Grant, President
Steve Kramer, Director of Laboratories
City
ST
Rachel Dutil, Administrative Assistant
Karen Lassell, Equine Manager
Zip
Time
Quantity
Morning
Break
Laurie Miller, Accounting / Payroll
Cafeteria
Housekeeping
Lunch
Afternoon
Break
Miner Center Custodial
Other
Dinner
GRAND TOTAL
Total
The William H. Miner Agricultural Research Institute
1034 Miner Farm Road
PO Box 90
Chazy, NY 12921
Print Form
Current Date
www.whminer.org
Submit by Email
2014-12-10 10:18:49
New Request
Revised Request
Facilities Request Form
Please complete the form below to request a reservation.
Visitor / Name of Event: Crop Congress
Wanda
Contact Information:
Submitted by:
Number Attending:
Rachel
Phone Number: ext. 117
Email Address:
[email protected]
Ext: 115
Events Begins: Date Tuesday, February 17, 2015
Time 10
a.m.
Events Ends: Date
Time 3
p.m.
Tuesday, February 17, 2015
Facilities Required
(List all that apply)
Miner Center Auditorium
Other Accomodations or Requests
85-100
BERC lobby
cafeteria annex
Please have vendor tables in the lobby and in the cafeteria annex. Wanda can confirm
number needed as date approaches.
See additional comments on back
Send Copies to:
Check all services that you will need:
Katie Ballard, Director of Research
Housekeeping
Kirk Beattie, Finance & Personnel Officer
Amy Bedard, Library
Cafeteria
After Hours
Coverage
Custodial Service
Bill the following services to:
Charge services to:
Steve Couture, Dairy Farm Manager
Wanda Emerich, Outreach Coordinator
Steve Fessette, Director of Physical Plant
Name
Address
Rick Grant, President
Steve Kramer, Director of Laboratories
City
ST
Rachel Dutil, Administrative Assistant
Karen Lassell, Equine Manager
Zip
Time
Quantity
Morning
Break
Laurie Miller, Accounting / Payroll
Cafeteria
Housekeeping
Lunch
Afternoon
Break
Miner Center Custodial
Other
Dinner
GRAND TOTAL
Total
Miner Institute - Chazy NY
Facilities Request Form
Page 2
Room Configuration
Traditional Speaker/Audience
Audio/Visual Equipment
Please check audio/visual equipment you will
need for your event (check all that apply):
Chalkboard
Digital Projection System
Tables in U Shape (18 maximum)
Dry Erase Board & markers
Easel, flipchart, & markers
Laser pointer
Overhead Projector
PA System
Slide Projector
Surge Protected Electrical Outlet Strip
Extra long phone cord
Television
VCR
Other
Tables in Two Rows (20 maximum)
Additional Comments
Tables in Rectangle (24 maximum)
Tables in Modified U Shape (36 maximum)
Chairs in a V-shape
The William H. Miner Agricultural Research Institute
1034 Miner Farm Road
PO Box 90
Chazy, NY 12921
Print Form
Current Date
www.whminer.org
Submit by Email
2014-12-19 11:14:33
New Request
Revised Request
Facilities Request Form
Please complete the form below to request a reservation.
Visitor / Name of Event: Tom Bull presentation for all staff
Rachel
Contact Information:
Submitted by:
Number Attending:
Rachel
Phone Number: ext. 115
Email Address:
[email protected]
Ext: 115
Events Begins: Date Thursday, February 19, 2015
Time 3
p.m.
Thursday, February 19, 2015
Time 5
p.m.
Events Ends: Date
Facilities Required
(List all that apply)
~40
Miner Center Auditorium
Other Accomodations or Requests
Please have some cookies, coffee and water available
See additional comments on back
Send Copies to:
Check all services that you will need:
Katie Ballard, Director of Research
Housekeeping
Kirk Beattie, Finance & Personnel Officer
Amy Bedard, Library
Cafeteria
After Hours
Coverage
Custodial Service
Bill the following services to:
Charge services to:
Steve Couture, Dairy Farm Manager
Wanda Emerich, Outreach Coordinator
Steve Fessette, Director of Physical Plant
Name
Address
Rick Grant, President
Steve Kramer, Director of Laboratories
City
ST
Rachel Dutil, Administrative Assistant
Karen Lassell, Equine Manager
Zip
Time
Quantity
Morning
Break
Laurie Miller, Accounting / Payroll
Cafeteria
Housekeeping
Lunch
Afternoon
Break
Miner Center Custodial
Other
Dinner
GRAND TOTAL
Total
Miner Institute - Chazy NY
Facilities Request Form
Page 2
Room Configuration
Traditional Speaker/Audience
Audio/Visual Equipment
Please check audio/visual equipment you will
need for your event (check all that apply):
Chalkboard
Digital Projection System
Tables in U Shape (18 maximum)
Dry Erase Board & markers
Easel, flipchart, & markers
Laser pointer
Overhead Projector
PA System
Slide Projector
Surge Protected Electrical Outlet Strip
Extra long phone cord
Television
VCR
Other
Tables in Two Rows (20 maximum)
Additional Comments
Tables in Rectangle (24 maximum)
Tables in Modified U Shape (36 maximum)
Chairs in a V-shape
The William H. Miner Agricultural Research Institute
1034 Miner Farm Road
PO Box 90
Chazy, NY 12921
Print Form
Current Date
www.whminer.org
Submit by Email
2015-01-14 08:51:48
New Request
Revised Request
Facilities Request Form
Please complete the form below to request a reservation.
Visitor / Name of Event: Dave Barbano
Number Attending:
Contact Information:
Submitted by:
Phone Number:
Rachel
Email Address:
[email protected]
Events Begins: Date Sunday, February 22, 2015
Events Ends: Date
1
Tuesday, February 24, 2015
Facilities Required
(List all that apply)
Ext: 115
Time
p.m.
Time
p.m.
Shadow Lawn Guest House
Other Accomodations or Requests
Dave will be joining the Dairy 2050 group on Feb. 24 so please just have Shadow Lawn ready
for the full group in advance of Dave's arrival. Thanks!
See additional comments on back
Send Copies to:
Check all services that you will need:
Katie Ballard, Director of Research
Housekeeping
Kirk Beattie, Finance & Personnel Officer
Amy Bedard, Library
Cafeteria
After Hours
Coverage
Custodial Service
Bill the following services to:
Charge services to:
Steve Couture, Dairy Farm Manager
Wanda Emerich, Outreach Coordinator
Steve Fessette, Director of Physical Plant
Name
Address
Rick Grant, President
Steve Kramer, Director of Laboratories
City
ST
Rachel Dutil, Administrative Assistant
Karen Lassell, Equine Manager
Zip
Time
Quantity
Morning
Break
Laurie Miller, Accounting / Payroll
Cafeteria
Housekeeping
Lunch
Afternoon
Break
Miner Center Custodial
Other
Dinner
GRAND TOTAL
Total
The William H. Miner Agricultural Research Institute
1034 Miner Farm Road
PO Box 90
Chazy, NY 12921
Print Form
Current Date
www.whminer.org
Submit by Email
2015-01-14 08:56:38
New Request
Revised Request
Facilities Request Form
Please complete the form below to request a reservation.
Visitor / Name of Event: research meeting with Dave Barbano
Number Attending:
Contact Information:
Submitted by:
Phone Number:
Rachel
Email Address:
[email protected]
Events Begins: Date Monday, February 23, 2015
Events Ends: Date
Monday, February 23, 2015
Facilities Required
(List all that apply)
Ext: 115
Time 8:30
a.m.
Time 12
p.m.
Miner Center Green Room
Other Accomodations or Requests
Dave will be staying for lunch.
See additional comments on back
Send Copies to:
Check all services that you will need:
Katie Ballard, Director of Research
Housekeeping
Kirk Beattie, Finance & Personnel Officer
Amy Bedard, Library
Cafeteria
After Hours
Coverage
Custodial Service
Bill the following services to:
Charge services to:
Steve Couture, Dairy Farm Manager
Wanda Emerich, Outreach Coordinator
Steve Fessette, Director of Physical Plant
Name
Address
Rick Grant, President
Steve Kramer, Director of Laboratories
City
ST
Rachel Dutil, Administrative Assistant
Karen Lassell, Equine Manager
Zip
Time
Quantity
Morning
Break
Laurie Miller, Accounting / Payroll
Cafeteria
Housekeeping
Lunch
Afternoon
Break
Miner Center Custodial
Other
Dinner
GRAND TOTAL
Total
The William H. Miner Agricultural Research Institute
1034 Miner Farm Road
PO Box 90
Chazy, NY 12921
Print Form
Current Date
www.whminer.org
Submit by Email
2015-01-05 10:33:15
New Request
Revised Request
Facilities Request Form
Please complete the form below to request a reservation.
Visitor / Name of Event: Dairy 2050 group
Rick
Contact Information:
Submitted by:
Number Attending:
Rachel
Phone Number: ext. 116
Email Address:
[email protected]
Events Begins: Date Tuesday, February 24, 2015
Events Ends: Date
Thursday, February 26, 2015
Facilities Required
(List all that apply)
3
Ext: 115
Time
a.m.
Time
p.m.
Director's Residence
Other Accomodations or Requests
please have snacks, coffee, beer, and wine available.
See additional comments on back
Send Copies to:
Check all services that you will need:
Katie Ballard, Director of Research
Housekeeping
Kirk Beattie, Finance & Personnel Officer
Amy Bedard, Library
Cafeteria
After Hours
Coverage
Custodial Service
Bill the following services to:
Charge services to:
Steve Couture, Dairy Farm Manager
Wanda Emerich, Outreach Coordinator
Steve Fessette, Director of Physical Plant
Name
Address
Rick Grant, President
Steve Kramer, Director of Laboratories
City
ST
Rachel Dutil, Administrative Assistant
Karen Lassell, Equine Manager
Zip
Time
Quantity
Morning
Break
Laurie Miller, Accounting / Payroll
Cafeteria
Housekeeping
Lunch
Afternoon
Break
Miner Center Custodial
Other
Dinner
GRAND TOTAL
Total
The William H. Miner Agricultural Research Institute
1034 Miner Farm Road
PO Box 90
Chazy, NY 12921
Print Form
Current Date
www.whminer.org
Submit by Email
2015-01-05 10:38:57
New Request
Revised Request
Facilities Request Form
Please complete the form below to request a reservation.
Visitor / Name of Event: Dairy 2050 group
Rick
Contact Information:
Submitted by:
Number Attending:
Rachel
Phone Number: ext. 116
Email Address:
[email protected]
Events Begins: Date Tuesday, February 24, 2015
Events Ends: Date
Thursday, February 26, 2015
Facilities Required
(List all that apply)
5
Ext: 115
Time
a.m.
Time
p.m.
Shadow Lawn Guest House
Other Accomodations or Requests
please have snacks, coffee, beer, and wine available.
See additional comments on back
Send Copies to:
Check all services that you will need:
Katie Ballard, Director of Research
Housekeeping
Kirk Beattie, Finance & Personnel Officer
Amy Bedard, Library
Cafeteria
After Hours
Coverage
Custodial Service
Bill the following services to:
Charge services to:
Steve Couture, Dairy Farm Manager
Wanda Emerich, Outreach Coordinator
Steve Fessette, Director of Physical Plant
Name
Address
Rick Grant, President
Steve Kramer, Director of Laboratories
City
ST
Rachel Dutil, Administrative Assistant
Karen Lassell, Equine Manager
Zip
Time
Quantity
Morning
Break
Laurie Miller, Accounting / Payroll
Cafeteria
Housekeeping
Lunch
Afternoon
Break
Miner Center Custodial
Other
Dinner
GRAND TOTAL
Total
The William H. Miner Agricultural Research Institute
1034 Miner Farm Road
PO Box 90
Chazy, NY 12921
Print Form
Current Date
www.whminer.org
Submit by Email
2014-12-16 09:40:08
New Request
Revised Request
Facilities Request Form
Please complete the form below to request a reservation.
Visitor / Name of Event: CCE Regional Calf Management Program Group
Kim Morrill
Contact Information:
Submitted by:
Number Attending:
Phone Number: (603)-568-1404
Email Address:
Wanda
Ext:
[email protected]
Events Begins: Date Thursday, February 26, 2015
Time 10:00
a.m.
Events Ends: Date
Time 3:00
p.m.
Thursday, February 26, 2015
Facilities Required
(List all that apply)
10
Miner Center Auditorium
Other Accomodations or Requests
Will need internet access for WebEx
See additional comments on back
Send Copies to:
Check all services that you will need:
Katie Ballard, Director of Research
Housekeeping
Kirk Beattie, Finance & Personnel Officer
Amy Bedard, Library
Cafeteria
After Hours
Coverage
Custodial Service
Bill the following services to:
Charge services to:
Steve Couture, Dairy Farm Manager
Wanda Emerich, Outreach Coordinator
Steve Fessette, Director of Physical Plant
Name
Kim Morrill, CCE Regional Dairy Specialist
send bill to e-mail above
Address
Rick Grant, President
Steve Kramer, Director of Laboratories
City
ST
Rachel Dutil, Administrative Assistant
Karen Lassell, Equine Manager
Zip
Time
Morning
Break
Quantity
Total
$2.50 - Snacks & beverages
10:00 AM
10
$25.00
$5.50 - Institute Lunch - < 20
noon
10
$55.00
Laurie Miller, Accounting / Payroll
Cafeteria
Housekeeping
Lunch
Afternoon
Break
Miner Center Custodial
Other
Dinner
GRAND TOTAL
Miner Institute - Chazy NY
Facilities Request Form
Page 2
Room Configuration
Traditional Speaker/Audience
Audio/Visual Equipment
Please check audio/visual equipment you will
need for your event (check all that apply):
Chalkboard
Digital Projection System
Tables in U Shape (18 maximum)
Dry Erase Board & markers
Easel, flipchart, & markers
Laser pointer
Overhead Projector
PA System
Slide Projector
Surge Protected Electrical Outlet Strip
Extra long phone cord
Television
VCR
Other
Tables in Two Rows (20 maximum)
Additional Comments
Tables in Rectangle (24 maximum)
Tables in Modified U Shape (36 maximum)
Chairs in a V-shape
The William H. Miner Agricultural Research Institute
1034 Miner Farm Road
PO Box 90
Chazy, NY 12921
Print Form
Current Date
www.whminer.org
Submit by Email
2014-12-19 08:32:58
New Request
Revised Request
Facilities Request Form
Please complete the form below to request a reservation.
Visitor / Name of Event: NNYADP Meeting
Amy Ivy
Contact Information:
Submitted by:
Number Attending:
Phone Number: 518-561-7450 x104
Email Address:
Wanda
Ext: 117
[email protected]
Events Begins: Date Friday, February 27, 2015
Time 10:00
a.m.
Events Ends: Date
Time 3:00
p.m.
Friday, February 27, 2015
Facilities Required
(List all that apply)
Miner Center Auditorium
Other Accomodations or Requests
~30
Miner Center Green Room
Miner Center Boardroom
also need Cafeteria Annex. They will be having a meeting in the Auditorium and breakout
sessions in the other rooms after lunch.
See additional comments on back
Send Copies to:
Check all services that you will need:
Katie Ballard, Director of Research
Housekeeping
Kirk Beattie, Finance & Personnel Officer
Amy Bedard, Library
Cafeteria
After Hours
Coverage
Custodial Service
Bill the following services to:
Charge services to:
Steve Couture, Dairy Farm Manager
Wanda Emerich, Outreach Coordinator
Steve Fessette, Director of Physical Plant
Name
Amy Ivy
Address
6064 Rte 22 Suite 5
City
Plattsburgh
CCE-NNYADP
Rick Grant, President
Steve Kramer, Director of Laboratories
ST NY
Rachel Dutil, Administrative Assistant
Karen Lassell, Equine Manager
Zip 12901
Time
Morning
Break
Quantity
$2.50 - Snacks & beverages
10:00 AM
30
> 20 - See Kirk for pricing
noon
30
Laurie Miller, Accounting / Payroll
Cafeteria
Housekeeping
Lunch
Afternoon
Break
Miner Center Custodial
Other
Dinner
GRAND TOTAL
Total
$75.00
Miner Institute - Chazy NY
Facilities Request Form
Page 2
Room Configuration
Traditional Speaker/Audience
Audio/Visual Equipment
Please check audio/visual equipment you will
need for your event (check all that apply):
Chalkboard
Digital Projection System
Tables in U Shape (18 maximum)
Dry Erase Board & markers
Easel, flipchart, & markers
Laser pointer
Overhead Projector
PA System
Slide Projector
Surge Protected Electrical Outlet Strip
Extra long phone cord
Television
VCR
Other
Tables in Two Rows (20 maximum)
Additional Comments
Tables in Rectangle (24 maximum)
They might move furniture around some to set up
for the breakout sessions.
Tables in Modified U Shape (36 maximum)
Chairs in a V-shape
The William H. Miner Agricultural Research Institute
1034 Miner Farm Road
PO Box 90
Chazy, NY 12921
Print Form
Current Date
www.whminer.org
Submit by Email
2015-01-09 14:10:15
New Request
Revised Request
Facilities Request Form
Please complete the form below to request a reservation.
Visitor / Name of Event: EquiDay speaker
Karen
Contact Information:
Submitted by:
Number Attending:
Rachel
Phone Number: ext. 120
Email Address:
[email protected]
Events Begins: Date Friday, March 20, 2015
Events Ends: Date
Sunday, March 22, 2015
Facilities Required
(List all that apply)
not sure
Ext: 115
Time
p.m.
Time
p.m.
Director's Residence
Other Accomodations or Requests
touch base with Karen on snacks/beverages.
See additional comments on back
Send Copies to:
Check all services that you will need:
Katie Ballard, Director of Research
Housekeeping
Kirk Beattie, Finance & Personnel Officer
Amy Bedard, Library
Cafeteria
After Hours
Coverage
Custodial Service
Bill the following services to:
Charge services to:
Steve Couture, Dairy Farm Manager
Wanda Emerich, Outreach Coordinator
Steve Fessette, Director of Physical Plant
Name
Address
Rick Grant, President
Steve Kramer, Director of Laboratories
City
ST
Rachel Dutil, Administrative Assistant
Karen Lassell, Equine Manager
Zip
Time
Quantity
Morning
Break
Laurie Miller, Accounting / Payroll
Cafeteria
Housekeeping
Lunch
Afternoon
Break
Miner Center Custodial
Other
Dinner
GRAND TOTAL
Total
The William H. Miner Agricultural Research Institute
1034 Miner Farm Road
PO Box 90
Chazy, NY 12921
Print Form
Current Date
www.whminer.org
Submit by Email
2015-01-09 14:12:07
New Request
Revised Request
Facilities Request Form
Please complete the form below to request a reservation.
Visitor / Name of Event: EquiDay
Karen
Contact Information:
Submitted by:
Number Attending:
Rachel
Phone Number: ext. 120
Email Address:
[email protected]
Ext: 115
Events Begins: Date Saturday, March 21, 2015
Time 8
a.m.
Saturday, March 21, 2015
Time 4
p.m.
Events Ends: Date
Facilities Required
(List all that apply)
~50
Miner Center Auditorium
Other Accomodations or Requests
cofee/water, pastries and fruit in morning, and make your own bag lunch at noon.
See additional comments on back
Send Copies to:
Check all services that you will need:
Katie Ballard, Director of Research
Housekeeping
Kirk Beattie, Finance & Personnel Officer
Amy Bedard, Library
Cafeteria
After Hours
Coverage
Custodial Service
Bill the following services to:
Charge services to:
Steve Couture, Dairy Farm Manager
Wanda Emerich, Outreach Coordinator
Steve Fessette, Director of Physical Plant
Name
Address
Rick Grant, President
Steve Kramer, Director of Laboratories
City
ST
Rachel Dutil, Administrative Assistant
Karen Lassell, Equine Manager
Zip
Time
Quantity
Morning
Break
Laurie Miller, Accounting / Payroll
Cafeteria
Housekeeping
Lunch
Afternoon
Break
Miner Center Custodial
Other
Dinner
GRAND TOTAL
Total
Miner Institute - Chazy NY
Facilities Request Form
Page 2
Room Configuration
Traditional Speaker/Audience
Audio/Visual Equipment
Please check audio/visual equipment you will
need for your event (check all that apply):
Chalkboard
Digital Projection System
Tables in U Shape (18 maximum)
Dry Erase Board & markers
Easel, flipchart, & markers
Laser pointer
Overhead Projector
PA System
Slide Projector
Surge Protected Electrical Outlet Strip
Extra long phone cord
Television
VCR
Other
Tables in Two Rows (20 maximum)
Additional Comments
Tables in Rectangle (24 maximum)
Karen will touch base on number of vendor tables
needed. Thank you!
Tables in Modified U Shape (36 maximum)
Chairs in a V-shape
The William H. Miner Agricultural Research Institute
1034 Miner Farm Road
PO Box 90
Chazy, NY 12921
Print Form
Current Date
www.whminer.org
Submit by Email
2014-12-22 16:19:43
New Request
Revised Request
Facilities Request Form
Please complete the form below to request a reservation.
Visitor / Name of Event: staff meeting
Number Attending:
Contact Information:
Submitted by:
Phone Number:
Rachel
Email Address:
[email protected]
Events Begins: Date Thursday, March 26, 2015
Events Ends: Date
~40
Thursday, March 26, 2015
Facilities Required
(List all that apply)
Ext: 115
Time 10:30
a.m.
Time 12
p.m.
Miner Center Auditorium
Other Accomodations or Requests
coffee, water and cookies please!
See additional comments on back
Send Copies to:
Check all services that you will need:
Katie Ballard, Director of Research
Housekeeping
Kirk Beattie, Finance & Personnel Officer
Amy Bedard, Library
Cafeteria
After Hours
Coverage
Custodial Service
Bill the following services to:
Charge services to:
Steve Couture, Dairy Farm Manager
Wanda Emerich, Outreach Coordinator
Steve Fessette, Director of Physical Plant
Name
Address
Rick Grant, President
Steve Kramer, Director of Laboratories
City
ST
Rachel Dutil, Administrative Assistant
Karen Lassell, Equine Manager
Zip
Time
Quantity
Morning
Break
Laurie Miller, Accounting / Payroll
Cafeteria
Housekeeping
Lunch
Afternoon
Break
Miner Center Custodial
Other
Dinner
GRAND TOTAL
Total
Miner Institute - Chazy NY
Facilities Request Form
Page 2
Room Configuration
Traditional Speaker/Audience
Audio/Visual Equipment
Please check audio/visual equipment you will
need for your event (check all that apply):
Chalkboard
Digital Projection System
Tables in U Shape (18 maximum)
Dry Erase Board & markers
Easel, flipchart, & markers
Laser pointer
Overhead Projector
PA System
Slide Projector
Surge Protected Electrical Outlet Strip
Extra long phone cord
Television
VCR
Other
Tables in Two Rows (20 maximum)
Additional Comments
Tables in Rectangle (24 maximum)
Tables in Modified U Shape (36 maximum)
Chairs in a V-shape
The William H. Miner Agricultural Research Institute
1034 Miner Farm Road
PO Box 90
Chazy, NY 12921
Print Form
Current Date
www.whminer.org
Submit by Email
2015-01-09 14:38:00
New Request
Revised Request
Facilities Request Form
Please complete the form below to request a reservation.
Visitor / Name of Event: Sammy Pittman Farrier
Karen
Contact Information:
Submitted by:
Number Attending:
Phone Number: ext. 120
Rachel
Email Address:
[email protected]
Ext: 115
Events Begins: Date Thursday, April 9, 2015
Time
p.m.
Sunday, April 12, 2015
Time
a.m.
Events Ends: Date
Facilities Required
(List all that apply)
1
Director's Residence
Other Accomodations or Requests
Karen will touch base if any snacks/beverages are needed.
See additional comments on back
Send Copies to:
Check all services that you will need:
Katie Ballard, Director of Research
Housekeeping
Kirk Beattie, Finance & Personnel Officer
Amy Bedard, Library
Cafeteria
After Hours
Coverage
Custodial Service
Bill the following services to:
Charge services to:
Steve Couture, Dairy Farm Manager
Wanda Emerich, Outreach Coordinator
Steve Fessette, Director of Physical Plant
Name
Address
Rick Grant, President
Steve Kramer, Director of Laboratories
City
ST
Rachel Dutil, Administrative Assistant
Karen Lassell, Equine Manager
Zip
Time
Quantity
Morning
Break
Laurie Miller, Accounting / Payroll
Cafeteria
Housekeeping
Lunch
Afternoon
Break
Miner Center Custodial
Other
Dinner
GRAND TOTAL
Total
The William H. Miner Agricultural Research Institute
1034 Miner Farm Road
PO Box 90
Chazy, NY 12921
Print Form
Current Date
www.whminer.org
Submit by Email
2015-01-09 14:47:51
New Request
Revised Request
Facilities Request Form
Please complete the form below to request a reservation.
Visitor / Name of Event: Sammy Pittman Farrier/Vet Clinic
Karen
Contact Information:
Submitted by:
Number Attending:
Phone Number: ext. 120
Rachel
Email Address:
[email protected]
Ext: 115
Events Begins: Date Friday, April 10, 2015
Time 8
a.m.
Friday, April 10, 2015
Time 1
p.m.
Events Ends: Date
Facilities Required
(List all that apply)
not sure
Miner Center Auditorium
Other Accomodations or Requests
Cafeteria- coffee/water/pastry/fruit, Lunch- Hot buffet of something easy. Should have preregistered #’s by March 31. Karen will touch base as date approaches.
See additional comments on back
Send Copies to:
Check all services that you will need:
Katie Ballard, Director of Research
Housekeeping
Kirk Beattie, Finance & Personnel Officer
Amy Bedard, Library
Cafeteria
After Hours
Coverage
Custodial Service
Bill the following services to:
Charge services to:
Steve Couture, Dairy Farm Manager
Wanda Emerich, Outreach Coordinator
Steve Fessette, Director of Physical Plant
Name
Address
Rick Grant, President
Steve Kramer, Director of Laboratories
City
ST
Rachel Dutil, Administrative Assistant
Karen Lassell, Equine Manager
Zip
Time
Quantity
Morning
Break
Laurie Miller, Accounting / Payroll
Cafeteria
Housekeeping
Lunch
Afternoon
Break
Miner Center Custodial
Other
Dinner
GRAND TOTAL
Total
Miner Institute - Chazy NY
Facilities Request Form
Page 2
Room Configuration
Traditional Speaker/Audience
Audio/Visual Equipment
Please check audio/visual equipment you will
need for your event (check all that apply):
Chalkboard
Digital Projection System
Tables in U Shape (18 maximum)
Dry Erase Board & markers
Easel, flipchart, & markers
Laser pointer
Overhead Projector
PA System
Slide Projector
Surge Protected Electrical Outlet Strip
Extra long phone cord
Television
VCR
Other
Tables in Two Rows (20 maximum)
Additional Comments
Tables in Rectangle (24 maximum)
The group will move to the horse barn in the
afternoon. Karen will let you know if additional setup
in the barn is needed.
Thanks!
Tables in Modified U Shape (36 maximum)
Chairs in a V-shape
The William H. Miner Agricultural Research Institute
1034 Miner Farm Road
PO Box 90
Chazy, NY 12921
Print Form
Current Date
www.whminer.org
Submit by Email
2014-12-22 16:20:29
New Request
Revised Request
Facilities Request Form
Please complete the form below to request a reservation.
Visitor / Name of Event: staff meeting
Number Attending:
Contact Information:
Submitted by:
Phone Number:
Rachel
Email Address:
[email protected]
Events Begins: Date Thursday, June 18, 2015
Events Ends: Date
~40
Thursday, June 18, 2015
Facilities Required
(List all that apply)
Ext: 115
Time 10:30
a.m.
Time 12
p.m.
Miner Center Auditorium
Other Accomodations or Requests
coffee, water and cookies please!
See additional comments on back
Send Copies to:
Check all services that you will need:
Katie Ballard, Director of Research
Housekeeping
Kirk Beattie, Finance & Personnel Officer
Amy Bedard, Library
Cafeteria
After Hours
Coverage
Custodial Service
Bill the following services to:
Charge services to:
Steve Couture, Dairy Farm Manager
Wanda Emerich, Outreach Coordinator
Steve Fessette, Director of Physical Plant
Name
Address
Rick Grant, President
Steve Kramer, Director of Laboratories
City
ST
Rachel Dutil, Administrative Assistant
Karen Lassell, Equine Manager
Zip
Time
Quantity
Morning
Break
Laurie Miller, Accounting / Payroll
Cafeteria
Housekeeping
Lunch
Afternoon
Break
Miner Center Custodial
Other
Dinner
GRAND TOTAL
Total
Miner Institute - Chazy NY
Facilities Request Form
Page 2
Room Configuration
Traditional Speaker/Audience
Audio/Visual Equipment
Please check audio/visual equipment you will
need for your event (check all that apply):
Chalkboard
Digital Projection System
Tables in U Shape (18 maximum)
Dry Erase Board & markers
Easel, flipchart, & markers
Laser pointer
Overhead Projector
PA System
Slide Projector
Surge Protected Electrical Outlet Strip
Extra long phone cord
Television
VCR
Other
Tables in Two Rows (20 maximum)
Additional Comments
Tables in Rectangle (24 maximum)
Tables in Modified U Shape (36 maximum)
Chairs in a V-shape
The William H. Miner Agricultural Research Institute
1034 Miner Farm Road
PO Box 90
Chazy, NY 12921
Print Form
Current Date
www.whminer.org
Submit by Email
2015-01-09 14:51:36
New Request
Revised Request
Facilities Request Form
Please complete the form below to request a reservation.
Visitor / Name of Event: Horsemanship Retreat participants
Karen
Contact Information:
Submitted by:
Number Attending:
Phone Number: ext. 120
Rachel
Email Address:
[email protected]
Events Begins: Date Friday, June 26, 2015
Events Ends: Date
Saturday, June 27, 2015
Facilities Required
(List all that apply)
~6
Ext: 115
Time
a.m.
Time
p.m.
Director's Residence
Other Accomodations or Requests
coffee/breakfast food/snacks. Karen will confirm as date nears.
See additional comments on back
Send Copies to:
Check all services that you will need:
Katie Ballard, Director of Research
Housekeeping
Kirk Beattie, Finance & Personnel Officer
Amy Bedard, Library
Cafeteria
After Hours
Coverage
Custodial Service
Bill the following services to:
Charge services to:
Steve Couture, Dairy Farm Manager
Wanda Emerich, Outreach Coordinator
Steve Fessette, Director of Physical Plant
Name
Address
Rick Grant, President
Steve Kramer, Director of Laboratories
City
ST
Rachel Dutil, Administrative Assistant
Karen Lassell, Equine Manager
Zip
Time
Quantity
Morning
Break
Laurie Miller, Accounting / Payroll
Cafeteria
Housekeeping
Lunch
Afternoon
Break
Miner Center Custodial
Other
Dinner
GRAND TOTAL
Total
The William H. Miner Agricultural Research Institute
1034 Miner Farm Road
PO Box 90
Chazy, NY 12921
Print Form
Current Date
www.whminer.org
Submit by Email
2014-12-22 16:20:59
New Request
Revised Request
Facilities Request Form
Please complete the form below to request a reservation.
Visitor / Name of Event: staff meeting
Number Attending:
Contact Information:
Submitted by:
Phone Number:
Rachel
Email Address:
[email protected]
Events Begins: Date Thursday, September 3, 2015
Events Ends: Date
~40
Thursday, September 3, 2015
Facilities Required
(List all that apply)
Ext: 115
Time 10:30
a.m.
Time 12
p.m.
Miner Center Auditorium
Other Accomodations or Requests
coffee, water and cookies please!
See additional comments on back
Send Copies to:
Check all services that you will need:
Katie Ballard, Director of Research
Housekeeping
Kirk Beattie, Finance & Personnel Officer
Amy Bedard, Library
Cafeteria
After Hours
Coverage
Custodial Service
Bill the following services to:
Charge services to:
Steve Couture, Dairy Farm Manager
Wanda Emerich, Outreach Coordinator
Steve Fessette, Director of Physical Plant
Name
Address
Rick Grant, President
Steve Kramer, Director of Laboratories
City
ST
Rachel Dutil, Administrative Assistant
Karen Lassell, Equine Manager
Zip
Time
Quantity
Morning
Break
Laurie Miller, Accounting / Payroll
Cafeteria
Housekeeping
Lunch
Afternoon
Break
Miner Center Custodial
Other
Dinner
GRAND TOTAL
Total
Miner Institute - Chazy NY
Facilities Request Form
Page 2
Room Configuration
Traditional Speaker/Audience
Audio/Visual Equipment
Please check audio/visual equipment you will
need for your event (check all that apply):
Chalkboard
Digital Projection System
Tables in U Shape (18 maximum)
Dry Erase Board & markers
Easel, flipchart, & markers
Laser pointer
Overhead Projector
PA System
Slide Projector
Surge Protected Electrical Outlet Strip
Extra long phone cord
Television
VCR
Other
Tables in Two Rows (20 maximum)
Additional Comments
Tables in Rectangle (24 maximum)
Tables in Modified U Shape (36 maximum)
Chairs in a V-shape
The William H. Miner Agricultural Research Institute
1034 Miner Farm Road
PO Box 90
Chazy, NY 12921
Print Form
Current Date
www.whminer.org
Submit by Email
2014-12-22 16:21:26
New Request
Revised Request
Facilities Request Form
Please complete the form below to request a reservation.
Visitor / Name of Event: staff meeting
Number Attending:
Contact Information:
Submitted by:
Phone Number:
Rachel
Email Address:
[email protected]
Events Begins: Date Thursday, December 3, 2015
Events Ends: Date
~40
Thursday, December 3, 2015
Facilities Required
(List all that apply)
Ext: 115
Time 10:30
a.m.
Time 12
p.m.
Miner Center Auditorium
Other Accomodations or Requests
coffee, water and cookies please!
See additional comments on back
Send Copies to:
Check all services that you will need:
Katie Ballard, Director of Research
Housekeeping
Kirk Beattie, Finance & Personnel Officer
Amy Bedard, Library
Cafeteria
After Hours
Coverage
Custodial Service
Bill the following services to:
Charge services to:
Steve Couture, Dairy Farm Manager
Wanda Emerich, Outreach Coordinator
Steve Fessette, Director of Physical Plant
Name
Address
Rick Grant, President
Steve Kramer, Director of Laboratories
City
ST
Rachel Dutil, Administrative Assistant
Karen Lassell, Equine Manager
Zip
Time
Quantity
Morning
Break
Laurie Miller, Accounting / Payroll
Cafeteria
Housekeeping
Lunch
Afternoon
Break
Miner Center Custodial
Other
Dinner
GRAND TOTAL
Total
Miner Institute - Chazy NY
Facilities Request Form
Page 2
Room Configuration
Traditional Speaker/Audience
Audio/Visual Equipment
Please check audio/visual equipment you will
need for your event (check all that apply):
Chalkboard
Digital Projection System
Tables in U Shape (18 maximum)
Dry Erase Board & markers
Easel, flipchart, & markers
Laser pointer
Overhead Projector
PA System
Slide Projector
Surge Protected Electrical Outlet Strip
Extra long phone cord
Television
VCR
Other
Tables in Two Rows (20 maximum)
Additional Comments
Tables in Rectangle (24 maximum)
Tables in Modified U Shape (36 maximum)
Chairs in a V-shape