Room booking request To make a booking please complete this form, or contact the coordinator on +61 3 9919 9140 for further information. Contact details Given Name: * Family Name: * Organisation: Address: Suburb: State: Postcode: Business Phone: Fax Number: Mobile Number: Email Address: * Booking details Purpose of booking: Campus: - None -Flinders LaneFlinders StreetFootscray ParkKing StreetMeltonNewportNicholson StreetSt AlbansSunshineWerribee Room Capacity: Room Number (If known): Room Type: - None -AuditoriumClassroomsComputer LaboratoriesSmall Meeting RoomTiered Lecture Theatre Date of hiring: Day12345678910111213141516171819202122232425262728293031 MonthJanFebMarAprMayJunJulAugSepOctNovDec Year201220132014 Start time: hour123456789101112 : minute000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859 am pm Finish time: hour123456789101112 : minute000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859 am pm Seating arrangement: - None -Chairs/Arm TablesFixedMovableTables and chairs Floor layout: Flat Tiered Audio visual facilities required: Comments: