Rental Form - Mountain West Institute

Mountain West Institute (MWI) Meeting Space Rental Form

Please complete the form below for each meeting you are requesting room reservations for. Rental fees include only the time specified in the contract. If additional set-up/break-down time is required, fees for that time will be applied in half-day increments. There is no guarantee of space availability for set-up/break-down outside of contracted time. If you are requesting reservations for several meetings or require assistance, please contact Jill Kingen at (303) 957-3274 or email events@mddsdentist.com.

Company / Organization

Name / Contact

MDDS Affiliation

Email Address

Address Line 1

Address Line 2

City, State, Zip

Phone

Meeting Start Date

Meeting End Date

Meeting Start Time

Meeting End Time

Set Up Start Time

Number of Meeting Attendees

Room(s) Requested Room(s) Requested All Rooms Auditorium A Auditorium B Auditorium B with lab benches Banquet Hall Board Room Wet Lab Clinic (specify # of chairs in box below) ?

Room Setup

No charge items you would like to request: No charge items you would like to request: Lectern HD document camera Global Dental Scope on mobile floor stand with HD Video Dry-erase board w/markers Apple MiniPort to VGA adapter Apple MiniPort to HDMI adapter VGA multi-computer switch HDMI multi-computer switch Electric hand-pieces, high speed, low speed & nose cone attachments available. (burs not provided) (30 sets) Lamps (44 available) Air Syringes (18 available) Air connections (18 available) Dust Collectors (15 available, sharable between 2 users) Other items not listed (list items in box below)

Additional charge items you would like to request: Additional charge items you would like to request: Flipchart w/markers Flipchart (post-it style) w/markers Bio-disposal arrangements Additional AV requirements

Event recording/broadcasting

How did you hear about the Mountain West Institute (MWI)?

Special instructions or requests

QUICK LINKS

Room Rental Info
Rental Calendar
Photo Gallery
Parking
Sponsorship

The MDDS is an ADA CERP Recognized Provider. ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry. MDDS designates courses for the number of CE hours listed with each course. MDDS credits are approved by the AGD for Fellowship and Mastership credits.

Course Disclaimer: MDDS makes every effort to present high caliber speakers in their respective areas of expertise. MDDS courses are offered as information only and not as financial, accounting, legal or other professional advice. Attendees must consult with their own professional advisers. In addition, each participant must decide the merit and practicality of the material presented. The ideas and comments expressed during the courses are not necessarily endorsed by or are those of MDDS. MDDS warns attendees about the potential risks of using limited knowledge when integrating new techniques into your practices.