The Zelda Langdale Learning Center Request Form to request/reserve time in The Zelda langdale Learning Center Step 1 of 2 50% Todays Date* Date Format: MM slash DD slash YYYYName* Organization Name Type of Organization*Non ProfitBusinessGroupCommunty IndividualNonprofits and some Community Benefit Organizations are eligible for a discounted room rate.Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Name* Registrants Name Phone*FaxEmail* Number of Attendees?*1 - 1011 -2526-5051- 100T.V UsageDo you need use of the T.V's?*YesNoOne or both?*OneBothHow are you connecting to the T.V/s?*Wifi (Streaming)Hardwire (Can connect in certain areas)Not sure, I might need helpDo you need to use the sound system for the T.V?*NoYesDo you need to use the sound system for the T.V's?*NoYesPlease Explain what you are using the T.V's for.*WIFI / EthernetDo you need use of the WIFI / Ethernet?*Yes WifiYes EthernetNoWhat do you need wifi / Ethernet for?*Sound SystemDo you need use of the sound system?*YesNoDo you need the microphone as well?*Yes (Hand Mic)Yes (Portable Mic)Yes (Both)No What Days/Times are you wanting to schedule?Tell us the Day and Time you would like to schedule the room.Are you wanting to schedule more than one day and time?*YesNoIs this a recuring reservation?*yesnoExample: Every wednesday at 7:00 PMDate* Date Format: MM slash DD slash YYYYTimes*StartEnd Add the times you wish to scheduleTotal Time*List Days & Times*List dates and times you would like to schedule use of The Zelda Langdale Learning Center in increments of 15 minutes (Hit Plus to add more days) DateStart TimeEnd Time Total Time for all days*List all applicableList the start date, end date, day of the week to recur, start time, and end time. (Use plus sign to add more days, time must be in 15 minute increments) Start DateEnd DateDay of The WeekStart TimeEnd Time Total reccuring Time for all days*Total reccuring days*CAPTCHA
