Simulation Center Session Booking Form

In order to facilitate the planning of your educational activity, please complete the following form. The simulation center coordinator will then review the information provided and contact you to confirm your booking. Please note that submitting this form does not guarantee a reservation.
  
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Should you need to make any changes or corrections to the logistics of your session (i.e. date, time, number of participants, etc.), please submit a second form detailing the changes.

Contact Information

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Name:
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Phone Number:
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E-mail:

General Information

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Date of Submission:
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Open the calendar popup.
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Department:
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Educational Activity:
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Participant(s):
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Session Instructor(s):

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Anticipated Number of Participants for Each Session:
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Preferred Date:
RadDatePicker
Open the calendar popup.
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Preferred Times:

Objectives

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Please provide a brief description of the learning objective(s) for this simulation session.

Resources Required

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Requiring assistance in developing simulation scenarios (need to book an extra meeting well in advance to simulation session)
Requiring assistance in skills lab session (please specify)
Equipment (please specify)
Security Code
Type Security Code