Innovative Learning Center Request Form

Please use this form to schedule time at the Innovative Learning Center.

**If this is a new activity, the request may require a consultation with the ILC staff. ** With each simulation activity
that is scheduled, we need to obtain information about the following requirements. All Request for simulation includes
Simulation Technologist support

1Demographics > 2Room Request > 3Scenario/Script Information > 4Additional Information
Department Name
Requester Name
Email
Phone Phone - ### - ### ####
Date Date / MM / DD YYYY
Start Time Start Time : HH MM AM/PM
End Time End Time : HH MM AM/PM
Which of the following best describes your affiliation?

Which of the following best describes your affiliation? Student Faculty External Leaner

Please note: If you are an external user, there will be a charge associated with using the Innovative Learning Center and its equipment. After completing the form, you will receive an invoice with the cost. The cost is determined by number of rooms, number of hours needed, and the amount and type of equipment needed.
Summary of Event