* denotes a required field

* Name

Title

* E-mail (Please ensure that this is an address at which you can be readily contacted)

* Telephone

* Position

This section is required for university / educational users

University / Institution

Department

For University of Adelaide users only, an Account Code is required as follows (and only for those bookings where charges apply; contact SAPAC if unsure of this):

Account Code e.g. UNIAD-0000-00-000-00-200X-00000000

For users at other institutions, please type "none" in the above box so that the form will be accepted.

This section is required for commercial users

Company Name

Company ABN

Company Postal Address

Company Telephone

Company FAX

* Facility you wish to book: (you may specify only one per form)

* Preferred date

* Preferred time

* Duration of booking

Alternative date

Alternative time

For multiple date requests (e.g. meeting series), please enter extra dates and times below (one date per line):

* Number of people present

* Purpose of the booking : (e.g. subject area)

VISUALISATION / HAPTICS: Software (and preferred OS if applicable) to be used : (e.g. Chimera, VMD, AVS etc)

VISUALISATION / HAPTICS: Special requirements : (e.g. software installation / testing- subject to discussion and acceptance by SAPAC)

This section is required for all users (Type of booking)

Is this booking for (select one)

Charges apply for use of SAPAC services and facilities. These may be viewed on the Charges page. In submitting this form, it is understood that you have agreed to the Conditions of Use and Charges.

* I have read, understand, and agree to the Conditions of Use and Charges for use of SAPAC services and facilities

Submission of this form does not, of itself, guarantee that the booking will take place as requested. All booking requests will be confirmed following the receipt of the request.