Music Building Reservation Request Form

Name*

First Name

Last Name

LSC ID#*

Email *

I Am A...*

Student Faculty Member Collaborative Pianist Music Tutor

I am requesting a reservation for the following date and time *

:

Please note all reservations will be for one-hour blocks beginning and ending on the hour. SAME DAY REQUESTS WILL NOT BE ACCEPTED. Please submit at least 72 hours in advance.

Purpose of the reservation? *

Personal practice?

If this is a private lesson, please indicate the full name of the student you are teaching*

Indicate "N/A" if this is not applicable

If this is a recurring reservation, please indicate how often you'd like it to recur*

Example: Every Wednesday from 11a-12p from 9/3-12/16. Students can only reserve for two weeks at a time and should submit their request the week prior to the desired dates.