RESERVATION REQUEST

First name

Last name

Company name

Email

Phone

Purpose of the Reservation

Meeting Date

Meeting Start Time

Meeting End Time

Are you the on-site contact person? If not, please provide the name and contact information.

Number of Attendees

Choose a Space

Questions or Concerns

I hereby verify the information to be true and complete and agree to the terms and conditions for the use of the AMIC facility.

I certify that I am authorized to sign contracts on behalf of the organization or group listed herein. I further certify that I have read and understand the terms and conditions for the use of AMIC facilities.

I hereby agree that organization or group will not make claim against, sue, attach the property of, or prosecute AMIC and its employees, officers, or officials.

I have read and agree to the terms and conditions

Electronic Signature

RESERVATION REQUEST

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AMIC

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