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Section 1 - Event Information |
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Event or Course Name & CRN:
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Event Date(s):
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Start Time:
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End Time:
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Recurring?: (If no, skip to next section) |
Yes
No |
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Start Date:
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End Date:
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Pattern:
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Section 2 - Requestor's Information |
| Name: |
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| Phone: |
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| Email: |
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| Department: |
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Section 3 - Origination |
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Origination (campus, building, room):
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VTC Unit (name, IP or E.164):
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Reserved: |
Yes
No |
Moderator's Name:
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Phone Number:
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Email:
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Section 4 - Endpoint 1 |
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Endpoint 1 (campus, building, room):
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VTC Unit (name, IP or E.164):
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Reserved: |
Yes
No |
Contact Person:
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Phone Number:
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Email:
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Section 5 - Endpoint 2 |
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Endpoint 2 (campus, building, room):
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VTC Unit (name, IP or E.164):
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Reserved: |
Yes
No |
Contact Person:
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Phone Number:
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Email:
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Section 6 - Endpoint 3 |
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Endpoint 3 (campus, building, room):
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VTC Unit (name, IP or E.164):
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Reserved: |
Yes
No |
Contact Person:
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Phone Number:
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Email:
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Section 4 - Special Requests |
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