REMEC Program Request - Internal

Complete this form to reserve a room at Munson Medical Center and space on the REMEC bridge for interactive (REMEC) programs only. You must complete a separate form for each program you are requesting.

If you have not received your facilitator/login and participant information within 24 hours of submitting this request, please call REMEC at 57944 to confirm your request has been received.



Email  *Name of Program  *Type of Program  *For GoToMeeting requests, please complete the GoToMeeting Request Form. You do not need to complete the remainder of this form. Number of Callers  *Event Date  *Start Time (Please note AM or PM)  *End Time (please note AM or PM)  *Department Name  *Department Number  *Number of Participants at Munson  *Scheduler's Name/Extension  *Facilitator or Contact Name/Extension  *A-V Equipment Needs 

Level of A-V Support Food Requested? (Administrative approval is mandatory for catering requests)  *Select Your Interactive Room (Use additional notes section at the bottom of the page to indicate a second room choice) 

Select REMEC Sites where you expect participants 

Additional Notes/Comments (Please provide any additional information to help us provide the best experience possible.) If you have any questions, please feel free to contact REMEC at 5-7944 or