Your First
Name: Your Last
Name:
Area Code:
Phone Number: Email Address:
Event Name:
First Date
of Conference - Month:
Day: Year:
Day of Week:
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
Start Time -
Hour: Minute:
End Time -
Hour: Minute:
Second Date
of Conference - Month: Day: Year:
Day of Week:
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
Start Time -
Hour: Minute:
End Time -
Hour: Minute:
Third Date
of Conference - Month: Day: Year:
Day of Week:
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
Start Time -
Hour: Minute:
End Time -
Hour: Minute:
If you have
more than three dates for a single event, please list extra
dates and times in the space provided below:
Number of
Conference Participants:
Presenter
will be at SFA Presenter will be elsewhere
N/A
Please list
any special room needs below. (Such as a document camera or
computer)
Please
list a location name and a technical contact at other site(s).
We must have this information in order to test connectivity
between SFA and the other connection location(s).
Receive Site
#1:
Site or
Institution Receiving Videoconference From SFA:
Site's
Videoconference Coordinator and/or Technician's Name - First:
Last:
Phone:
Email:
If SFA
will be sending video to more than one site, please provide
contact information for each additional location in the space(s)
below:
Receive Site
#2:
Institution
Receiving Videoconference From SFA:
Site's
Videoconference Coordinator and/or Technician's Name - First:
Last:
Phone:
Email:
Receive Site
#3:
Institution
Receiving Videoconference From SFA:
Site's
Videoconference Coordinator and/or Technician's Name - First:
Last:
Phone:
Email:
Receive Site
#4:
Institution
Receiving Videoconference From SFA:
Site's
Videoconference Coordinator and/or Technician's Name - First:
Last:
Phone:
Email:
Receive Site
#5:
Institution
Receiving Videoconference From SFA:
Site's
Videoconference Coordinator and/or Technician's Name - First:
Last:
Phone:
Email:
For more
than 5 additional receive sites, please list location and
technician contact information for each in the space
provided:
If you
have questions or need additional information about videoconferencing
at SFASU, please email: rwatson@sfasu.edu
Please check that all above
information is complete and correct. We cannot process requests
with incomplete information.
