Rubloff 11 Room Reservation Request Form

If you do not have access to the VEMS site please fill out this form to request space on Rubloff 11.

Please note:

These rooms are for business meetings only -- no classes or student seminars, parties, retreats or social activities should be scheduled in these rooms.

If you require AV assistance/support/set-up, it is your responsibility to obtain AV/IT support at least 48 hours in advance of the meeting. Last minute requests may not be accommodated. AV assistance should be arranged through the NUIT help desk or your department's internal IT support.

Department
1st Contact Name
1st Contact Phone Number 1st Contact Phone Number - ### - ### ####
1st Contact Email
2nd Contact Name
2nd Contact Phone Number 2nd Contact Phone Number - ### - ### ####
2nd Contact Email
NU Chart String Number - This must now include a five digit account code

Please Note: You must add your Chartstring Fund, Department and Account Code in order for your request to be processed. FSM does not charge room rental fees. Chart Strings are required in case of no shows, late cancellations or damages.
Date Date / MM / DD YYYY
Do you have additional or alternate dates?

Do you have additional or alternate dates? Yes - Additional Yes - Alternate
Type Additional Dates here
Type Alternate Dates here
Start Time
Please consider any set-up that may be required when requesting a start time. Start Time
Please consider any set-up that may be required when requesting a start time. : HH MM AM/PM
End Time
Please consider any clean-up that may be required when requesting an end time. End Time
Please consider any clean-up that may be required when requesting an end time. : HH MM AM/PM
Event Title
Event Types

Please familiarize yourself with the event types before choosing the most appropriate one for your event (a brief description of each is listed below):

Department Research: Experiments and exploration of ideas that are not externally funded; nor are they discrete projects separately budgeted and accounted for.

Industry Clinical Trial: Clinical trials funded by industry, typically pharmaceutical companies; participation of human subjects.

Instruction: Teaching activities, training activities supported by institutional funds.

Non-University Activity: Space used by a non-NU entity.

Other Institutional Activity: NU public service, unallowable activities, student activities, auxiliary enterprises, and agency activity.

Other Sponsored Activity: Sponsored public service, contract for service activities, seminar and conferences.

School/Department Administration: Administrative space in academic units.

Sponsored Research: Space for externally funded research and development, university research, and cost sharing benefiting this research; this research is separately budgeted and accounted for.

Sponsored Training: Training activities funded by outside agencies and organizations.

Student Services Administration: Administration of student affairs and for services to students.
Event Type
Number of participants
Audio Visual: Please indicated if you plan to use AV for this event. (Please Note: AV equipment may not be available in each room. If you select "Yes" for AV needs, please read the AV notes at the top of this form.)

Audio Visual: Please indicated if you plan to use AV for this event. (Please Note: AV equipment may not be available in each room. If you select "Yes" for AV needs, please read the AV notes at the top of this form.) Yes No
Catering: Please indicate if you plan to provide refreshments at this event.

Catering: Please indicate if you plan to provide refreshments at this event. Yes No
Rubloff 11 Rooms (capacity).
Please check all requested rooms.

Rubloff 11 Rooms (capacity).
Please check all requested rooms. Lakeview Conference Room (18) Streeterville Conference Room (10) Lincoln Park Conference Room (6) South Loop Conference Room (6)
Notes
Please provide any additional information about your event
11th Floor Rubloff Conference Room Policy

The conference rooms on Rubloff 11 include: the Lakeview Conference Room, the Lincoln Park Conference Room, the South Loop Conference Room, and the Streeterville Conference Room. These rooms are managed by the department on that floor and all questions regarding the space should be directed to (312) 503-1709 or nucats@northwestern.edu.

Please note: If you require AV assistance/support/set-up, it is your responsibility to obtain AV support at least 48 hours in advance of the meeting. Last minute requests may not be accommodated. AV assistance should be arranged through NUART.

Reservations
• Reservations must be made through VEMS (https://fsmportal.northwestern.edu/VirtualEMS/) or 11th Floor reception prior to use of the conference room.
• The conference room is not open to the public, staff or students without a reservation. If you need the room immediately, check with 11th Floor reception prior to using the room.
• For AV Support in the Streeterville or Lakeview Conference Rooms, please contact NUART at smartcls@listserv.it.northwestern.edu or at x7-ROOM.

Lights and Locking Up
• In all 11th floor conference rooms, turn off the lights, and projector if applicable. Not doing so will result in a $25 fine charged to the chart string provided in the reservation confirmation.
• In the 11th floor Lakeview Conference room, lock the door at the end of your meeting if there is no meeting immediately following (check the schedule posted on the door). Not doing so will result in a fine of $25 charged to the chart string provided in the reservation confirmation.

Main Doors
• When there is no receptionist on duty, the main office doors must remain closed and locked (including before 8 a.m. and after 5 p.m.). If you have access to the 11th floor space with your keycard, you may allow visitors to use the restrooms, but please DO NOT prop the door open. THIS IS A SAFETY ISSUE!
• If no one from 11th FL Rubloff is present in the meeting, participants must use the public restrooms on the 1st floor.

Lakeview Conference Room Key
• For meetings in the Lakeview Conference Room before and after business hours, a room key must be checked out at the 11th Floor Rubloff reception desk prior to 5 p.m.
• The key must be returned the following day.
• Unreturned keys will incur either a late fee of $10 per day, or, in accordance with FSM policy, a replacement fee of $100, charged to the chart string provided in the reservation confirmation.
11th Floor Rubloff Conference Room Policy and Confirmation Conditions

11th Floor Rubloff Conference Room Policy and Confirmation Conditions I understand and agree to the policies as listed above. By clicking this box, I agree to follow the policies outlined above.

Rubloff 11 Room Reservation Request Form

Rubloff 11 Room Reservation Request Form

Event Types Please familiarize yourself with the event types before choosing the most appropriate one for your event (a brief description of each is listed below):

11th Floor Rubloff Conference Room Policy

Event Types

Please familiarize yourself with the event types before choosing the most appropriate one for your event (a brief description of each is listed below):