Erie County DHSES|Classroom Facility Use Request Form#1050

Complete this form to request use of classroom (only) facilities at the Erie County DHSES Training & Operations Center located at 3359 Broadway-Cheektowaga NY 14227.

Use of the Erie County DHSES Training & Operations Center is open to county, state and federal public safety and allied health agencies, organizations and non-government organizations. Facility use fees may apply for non-related commercial and non-profit organizations. The facility offers (3) 24-seat classrooms; (1) 24-seat conference/class room; and (1) 105-seat auditorium.

This does not confirm that the facility is available or that your request has been confirmed - only that we have received your online request.

A copy of your completed request form will be emailed back to you, acknowledging receipt of your request in our online system. That email will form the basis of all future communications related to your facility request. You will receive future acknowledgements indicating that your request is either Pending, Confirmed or Declined depending on facility availability and other conditions.

Please contact Diane Overhoff in our EMS Division with any questions or concerns related to your facility request: diane.overhoff@erie.gov or 716-681-6070.

All Erie County Training Facilities are Tobacco (Chew), Smoke and Vapor (E-Cigarette) FREE. USE OF THESE PRODUCTS IS PROHIBITED ON PROPERTY.

Read all notes.

Event Title/Training Objective

Organization Requesting Use of Facility

Primary Contact

Title

Cell Phone

Please email copy of this request to

Purpose of Use

Equipment Needed (Select All that Apply)

Standard Room Equipment Only: LCD projector, screen; DVD player, TV, tables and chairs.

Video Conferencing (Data/Usage charges may apply)

Teleconference (Speaker phone provided as available. Teleconference phone bridge provided by user.)

Satellite Downlink (Programmable Analog Dish)

Primary Date Requested

Secondary Date Requested (If Primary Date is not available)

Alternate Date Requested (If Primary or Secondary Dates are not available)

Open Time

Close Time

Total Number of Participants Expected to Attend

Will you need a Facility Host/Instructor?

Yes (Specify preference below if you have one)

Preferred Instructor(s)

Comments/Special Requirements

NOTES:

All classrooms are outfitted with VGA connected LCD projector and ceiling mounted screen; DVD player and TV; tables and chairs. Room arrangement/reset is user responsibility.
Spectrum Cable WiFi is present in the building, subject to availability and total usage.
Facility user/presenter is responsible for providing laptop, wireless mouse, computer speakers, office/presentation supplies. No copy/print service available.
No food and beverage service available on site. Coffee, pop, candy and snack machines available in west lobby. Organization using the facility must secure F&B including utensils, paper products and supplies. Set-up, tear down and clean-up is responsibility of facility user.
For use of hands-on training facilities (including indoor drill tower) complete and submit Form #1060. Outdoor facilities are typically available for use from May 1st thru October 31st. Agencies using hands-on facilities must comply with Erie County Fire Safety Policies regarding safety and student participation. See www.erie.gov/FIRE for details.
Complete one form for each day facility use is requested.
Use of the Erie County DHSES Training & Operations Center is open to county, state and federal public safety and allied health agencies, organizations and non-government organizations. Facility use fees may apply for non-related commercial and non-profit organizations. Call 716-681-6070 to determine potential fees and other considerations.