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Technology Training Lab Request Form

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Please enter the following information. (All fields with * are required)

Lab Form

Your Name: * Required
Phone Number: * Required Invalid Phone Number
Room Number: * Required
Date:
1. Start Date Required
2. End Date Required
Please choose starting time: * Required
Please choose ending time: * Required
Software and Version (new installations require minimum 11 user licenses):
* Required
Class Trainer's Name * Required
Class Trainer's Phone Number: * Required
Test Person's Name * Required
Test Person's Phone Number: * Required

Personnel ID: Enter last 5 digits of Library Barcode: 205490000, or 10 digits of NIH Badge * Required Must be at least 5 digits
Building: * Required
Email: * Required * Invalid email
Program: * Required
Class Title: * Required
Please choose number of students: * Required
Purpose for using lab: * Required
Lab Usage - One Time? * Required
Software Source? * Required
Is Software Already Installed? * Required
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