Request For Time on Professor George Smoot's Calendar

**This form should be used to request time on Professor George Smoot's
Calendar.**

+-----+----------------------------+----+----------------------+-----+
|     | *Return completed form     |    | *Address questions   |     |
|     | to:*                       |    | to:*                 |     |
|     |                            |    |                      |     |
|     | Matisse Roach              |    | Matisse Roach, (510) |     |
|     |                            |    | 486-6872             |     |
|     | Lawrence Berkeley National |    |                      |     |
|     | Laboratory                 |    | <mroach@lbl.gov> or  |     |
|     |                            |    |                      |     |
|     | 1 Cyclotron Road, MS       |    | Melissa Barclay,     |     |
|     | 50R-5005                   |    | (510) 486-5237       |     |
|     |                            |    |                      |     |
|     | Berkeley, CA 94720-8159    |    |                      |     |
|     |                            |    |                      |     |
|     | FAX: 510) 486-7149         |    |                      |     |
+-----+----------------------------+----+----------------------+-----+
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+-----+----------------------------+----+----------------------+-----+

## **Event Information**

Title:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
Location: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Date: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Alternate Date:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Start time: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ End time:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Purpose of Event:

Lecture Interview Attendance only Short talk

Dinner party Other (please explain):
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Type of Event (check all that apply):

Breakfast Lunch Buffet Reception Dinner

Ceremony Other (please explain):

Type of Attire: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Requester will pay: Airfare Hotel All Travel Honorarium Other

In case Professor George Smoot is not available, please indicate a
possible alternative:

Video conference Questionnaire Phone call

Alternate Speaker? \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Other (please
explain):

***[\* \* \* \* IMPORTANT \* \* \* \*]{.mark}***

1.  ***Please include on a separate sheet of paper: Details of the
    event, (agenda) including\
    proposed guest list, the role of Professor Smoot, other speakers,
    the flow of the event,\
    etc.***

***2. Please provide any other information that will help Professor
George Smoot to make\
an informed decision.***