Rubloff 9 Room Reservation Request Form

If you do not have access to the VEMS site please fill out this form to request space on Rubloff 9.

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.

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.
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)

Audio Visual: Please indicated if you plan to use AV for this event. (Please Note: AV equipment may not be available in each room) 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 9 Rooms (capacity).
Please check all requested rooms.

Rubloff 9 Rooms (capacity).
Please check all requested rooms. Lake Shore Conference Room (22) Fairbanks Conference Room (10) Chicago Conference Room (6) Superior Conference Room (6)
Notes
Please provide any additional information about your event
9th Floor Rubloff Conference Room Policy

9th Floor Rubloff Conference Room Policy

The conference rooms on Rubloff 9 include: the Lake Shore Conference Room, Chicago Conference Room, the Fairbanks Conference Room, and the Superior Conference Room. These rooms are managed by the Office of Development & Alumni Relations and all questions regarding the space should be directed to the Reception desk of the FSM Development and Alumni Relations Office at (312) 503-8933.

Reservations
- Development & Alumni Relations reserves the right to reassign a confirmed reservation should an unforeseen priority arise.
- The conference room is not open to the public, staff or students without a reservation.
- It is suggested that you build into your meeting request a cushion of time (approximately 15 minutes) before and after your meeting for set-up or clean-up time or to avoid the possibility of your meeting or a prior meeting going over time.

Conference Room Hours and Room Use
- Conference room hours are from 8:30 a.m. - 4:30 p.m. Monday through Friday.
- Conference rooms are for business meetings - No classes, student seminars, parties, retreats, social activities are allowed.
- Conference rooms should be left clean and orderly upon close of meetings and not doing so may result in a clean-up fee charged to chart string provided in the reservation.

AV Assistance
- The Fairbanks Conference Rooms is the only conference room that has AV capabilities. If AV assistance is required, it is the requesters' responsibility to obtain AV support at least 48 hours in advance of the meeting. For AV Support in the Fairbanks Conference Room, please contact NUART at smartcls@listserv.it.northwestern.edu or at x7-ROOM.

Please note: the remaining 9th floor conference rooms do not have the following:
- Projectors, laptops, cables, cords, stands or speakers; all technical items are the responsibility of the requester and we do not provide any technical support.

The rooms do have the following:
- Single line basic speaker phones in two 6-seat conference rooms; the larger rooms, Lake Shore and Fairbanks have Polycom IP 7000 phones
- Projection screens or a white board
- NU wireless capabilities and also wired access plug-in
9th Floor Rubloff Conference Room Policy and Confirmation Conditions

9th 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 9 Room Reservation Request Form

Rubloff 9 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):

9th 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):