Requesting the Use of a Nationality Room

Complete this form to request Nationality and Heritage Room access for any University-affiliated event (examples include special lecture, interview, dissertation defense, Pitt-sponsored video project or any other academic-related use). Please note that food, drink, political meetings and rallies are prohibited. You will be contacted by NRIEP staff to confirm your request.

(This form is only for affiliates of the University of Pittsburgh to use. Organizations external to the University of Pittsburgh should reach out to nationalityrooms@pitt.edu concerning use of the spaces.)

Name *

University Department *

Telephone Number *

Email *

Are you the individual who is responsible and will be on site the day of the event? *

Please provide a contact name, telephone number, and email for the individual who will be onsite and responsible for the event.

Name

Telephone Number

Indicate the day and time of your event. If requesting multiple days (and times), please indicate the first day, and note the following requested days in the additional notes.

Date *

Month

Day

Year

Start Time *

Hour

Minute

End Time *

Hour

Minute

Please indicate the time you will need access to enter and exit the room: *

Additional Notes

Requested room(s) *

Number of attendees *

Name of event/lecture/defense/project *

Purpose of the request *

Please provide a brief rationale for requesting the use of a Nationality or Heritage room for this event: *

Would you be interested in a presentation about the room, either in person or with a video beforehand? *

Requesting the Use of a Nationality Room

(This form is only for affiliates of the University of Pittsburgh to use. Organizations external to the University of Pittsburgh should reach out to nationalityrooms@pitt.edu concerning use of the spaces.)

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