CLRC New Event Proposal

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This form is only for events that have never occured in the CLRC. Check out the decision tree on the previous page if you are unsure.
If you are a student wanting to schedule extra practice or filming, please use the Event Request form.
Requestor Contact Information
Full Name *
Email *
Phone Number Phone Number * - ### - ### ####
Associated TAMU College *
Is this a brand new event, or a curent event you would like to significantly modify? *

Is this a brand new event, or a curent event you would like to significantly modify? New Event Current Event with Modifications
Other faculty or staff involved with event planning *
Have you met with administration in your department about implementing this event?

Have you met with administration in your department about implementing this event? Yes No I don't know Other Other
Have you met with CLRC administration about implementing this event? *

Have you met with CLRC administration about implementing this event? Yes No I don't know
How will this event be funded? *

How will this event be funded? I'm applying for a grant I've recieved grant funding My department will fund this event I'm not sure and need guidance My interest group/club/organization will fund this event Other Other
Event Information
Event Name *
Host site *
Desired event date Desired event date * / MM / DD YYYY
Additional dates
List additional dates needed in this format 1/12/12, 2/14/13, etc.
What are your overall goals for this event?
How many participants do you anticipate? *
Will video recording be needed? *

Will video recording be needed? Yes No
Will standardized patients be needed? *

Will standardized patients be needed? Yes No
Will a high fidelity manikin be needed for a simulation? *

Will a high fidelity manikin be needed for a simulation? Yes No
Standardized Patient Request
Please list any pertinent information regarding SPs:
Is there any other information you would like to share?
Upload any event related documents

Attach Files
For a new event we ask for a 12 week lead time. We will do our best to accomodate new event requests submitted after this date.

Please take a moment to review our CLRC Procedures

CLRC New Event Proposal

Are you completing the correct form?

Requestor Contact Information

Event Information

Standardized Patient Request

For a new event we ask for a 12 week lead time. We will do our best to accomodate new event requests submitted after this date.