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Video Conference Reservation Form

Please fill out as much information as you can. The more technical parts such as IP address and equipment type can always be determined later.

Contact Info:

Name:
Organization/Department:
Phone:
Email

Conference Details:

Name of Conference:
Conference Date:
Start Time:       AM PM

End Time:         AM PM
Number of People:
Connection Type: IP ISDN
Who will initiate the call?
Special requirements:  
Recording/PowerPoint/Document camera or Live streaming


Far End Contact Information

Main Contact:
Phone:
Email:
Tech Contact:
Phone:
Email:
Room Phone:
Equipment Model:
IP Address:
ISDN #

Additional Comments