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Clinical and Translational Science Institute

UNIVERSITY of FLORIDA

Request for CTRB Shared Space

This form is for use by UF/CTSI leadership, faculty and staff. Otherwise, contact Jason Haugh, CTRB Facilities Administrator, at jhaugh@ufl.edu.

Requestor's Name*
First Last
Email*
Phone
Date of Event*
MM slash DD slash YYYY
Start Time of Event*

:
End Time of Event*

:
Space(s) Requested*
- CTSI 3256
- 2161 North
- 2161 South
- 3161
- 3162
- CTRB Cafe (3160)
- CTRB Lobby (i.e. for large networking events)
Please describe how we can assist you.*
How many attendees do you estimate for this event?*
What is the title of the event?*
Will refreshments of any kind be served?*
- Yes
- No