BioSkills Facility Booking

Facility Booking Form
Please complete the following form to request a workshop at the Bioskills Education Center. Please fill out all required fields. This form reserves the requested date for you for 5 business days. The workshop will not be confirmed until you sign and approve the price quotation.

Requested By*
Telephone Number(xxx-xxx-xxxx)*
Email*
Company*
Address*
City, State Zip*	,
Billing Info. (If different)
Billing Address
Billing City, State Zip	,
Billing Email
Billing Telephone
Proposed Workshop Date(s)*
Rental Hours*	Weekdays - Monday through Thursday Morning 8:00AM to Noon Afternoon 12:00PM to 4:00PM Evening 5:00PM to 9:00PM Full Day 8:00AM to 4:00PM Weekends - Friday, Saturday & Sunday Full Day 8:00AM to 4:00PM
Number of Stations*
Theme of Workshop - Lecture/Lab (Name of Course and proposed lab procedures)*
Specimens (Please be specific in Quantity and Type)
Number of Attendees*
Endoscopic Equipment*
Instrumentaion (Bioskills provides basic instrumentation. Specialty surgical devices are either to be supplied by our client or rented by Bioskills)
C-Arm*	No: Yes: / Quantity:
CT Scans*	No: Yes: / Quantity:
MRI *	No: Yes: / Quantity:
X-rays*	No: Yes: / Quantity:
Conference Room*	No: Yes: /
Special A/V Needs (Please list.)
Catering Requirements	Breakfast Lunch Dinner Snacks Special Requirements:
Caterers	Felicos Catering
Hotel Accommodations
Hotels	Inn At Great Neck
Transportation Requirements
Car Services	Camelot Limo