Milwaukee Center for Independence: Assisting individuals with special needs

Online Reservation Form


General Information

Name: Phone:
Organization: Cell Phone:
E-mail: Fax:

Meeting/Event Information

Date(s) of Event: 
Time(s) of Event:
Event Title:
Number of Attendees:
Type of Room Set-up Needed: Classroom Groups U Shape Hollow Square
Other   (If Other, please specify):

Media Services/Conference Services Information

Media services/conference services needs:
LCD Projector Flip Chart
Laptop Computer Dry Erase Board
Document Camera VCR Player
Wireless Microphone DVD Player
Internet Access  

Catering Information

Catering Needed?        Yes  No
If yes, please indicate all that are applicable:

Continental Breakfast
Light Refreshments

Other (specify)

Additional Information

Will any of your attendees need special accommodation?  Yes No
     If Yes, please specify:


MCFI Pediatric Skilled Nursing is
Accredited by the Joint Commission. MCFI core programs are accredited by CARF


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