Videoconference Request Form
Requested information 2 weeks prior to conference if possible

Requestor's Information

Person requesting conference
Date of conference
Room requested
Number of participants
Conference start/End time
Length of conference
Is conference to be recorded?
Peripherals requested (VCR, Document camera, computer)
Technical Contact Information (For site to remote site connection)
Institution or name of organization
Technical contact name
Contact phone number
(Please use one form for each site.)