Venue Information Request Form

JHM myLearning Venue Request Form
Click here to Review the current Venues in myLearning
JHM myLearning Venue Contact Information

Venue Contact is the person who is in charge of the venue.
Is the Venue Contact different than the person filling this form?*
Your Full Name
Your Email
Venue Contact Information
First Name*
Last Name*
Email Address*
Phone Number
Role
Other - Role
Organization*
Other Organization
Secondary Organization? Please specify
Secondary or Alternative Contact
Old myLearning Venue Information
Does it already exist in the system?*
[Old] Venue Name
[Old] Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
[Old] Contact Name
[Old] Contact Phone
[Old] Room Name
[Old] Room Location
NEW myLearning Venue Information
[New] Venue Name*
Building / Location
[New] Venue Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
[New] Room Name*
[New] Room Location*
Room Maximum Capacity*
Room Size / Type
[New] Contact Name*
[New] Contact Phone*
Organization / Group Affiliation (if any)
Other Organization
Building Security
Additional Notes
Please select that are available

LaptopLCDTVFlipchartsMarkersSatellite FeedPhone
Other (Explain)
Instructor Access to Room
Nearby Hotels
Driving Directions
Parking Information
Date
Signature*
JHM myLearning Support Team

Johns Hopkins Medicine International
1300 Thames Street , Suite 200
Baltimore, MD 21231

JHM myLearning Support Team | All rights reserved.

Please direct any questions to eLearn@jhmi.edu
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JHM myLearning Venue Request Form

Click here to Review the current Venues in myLearning

JHM myLearning Venue Contact Information

Venue Contact Information

Old myLearning Venue Information

NEW myLearning Venue Information