Resource Room Booking Request

This form is to request a booking for The Harriet Tubman Institute's Resource Room (YL 314).

Name of Event Contact Name of Event Contact * First Last
Job/Position Title *
York Email Address (enter another email address if you do not have a York email) *
Cellular Phone Number Cellular Phone Number * - ### - ### ####
Name of Signing Officer (supervisor/director/cost centre owner, etc.) Name of Signing Officer (supervisor/director/cost centre owner, etc.) * First Last
Signing Officer York Email Address *
Job/ Position Title *
Event Details
Event Start Date Event Start Date * / MM / DD YYYY
Event End Date Event End Date * / MM / DD YYYY
Event Start Time Event Start Time * : HH MM AM/PM
Event End Time Event End Time * : HH MM AM/PM
Event Frequency - If you're requesting multiple dates/times for an event, please list them here. *
Event Title *
Event Description *
Maximum of 800 words allowed. Currently Entered: 0 words.
Number of Participants. Maximum capacity is 30. *
Must be a number less than or equal to 30.
Will food be served at this event? *

Will food be served at this event? Yes No

Please note Tubman is not responsible for catering.
If food will be served at this event, please upload the cleaning services confirmation.

Attach Files
List any computer or audio/visual quipment (projector, microphones, etc.) required for your event. Note that there is currently no technical equipment in the Resource Room. *
Resource Room Rules & Guidelines

• Please note that classes are not permitted in these rooms.
• Ensure that all furniture/room equipment is reset to the original setting (tables
arranged in a rectangle) before you leave the space.
• HTI is not responsible for the set-up or operation of A/V equipment in the room. For
assistance, please email askit@yorku.ca or call ext. 55065.
• Do not remove any furniture, desks, chairs, or books from the rooms.
• Do not damage the walls/tack posters onto the walls. This can cause damage to the
interior.
• Do not leave garbage/food behind in the room (on chairs, tables or floor). If
additional garbage bags are required, please make arrangements with Facilities at
ext. 22401.
• If you no longer need the room, please provide 24 hours' notice of cancellation by
sending an email to tubman@yorku.ca.
• If you do not return the key for the room, your cost-centre will be charged the cost for replacing the key.
Cost Centre
Your cost-centre will only be charged the cost for replacing the key if it is lost or not returned; or if cleaning services is required. *
I agree to the Harriet Tubman Institutes' Resource Room Rules and Guidelines.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.

Resource Room Booking Request

Resource Room Booking Request

Event Details

Resource Room Rules & Guidelines