Videoconferencing Request Form

Event details

Date of event:

Start time of event: End time of event: (Times must be within the Universities Business hours unless other arrangements have been arranged)

Number of people will be attending event:

Location:

Special Requirements/Comments :

Purpose of videoconference event

Academic Course

Course #:

Departmental Meeting

Department Name/Number:

Grad Student Interview

Comments:

Other

Description:

Brown contact information

Name: Phone:

Department: Email address:

Has the host of the conference used this service before? Yes No

Remote user(s) contact information

Name:

Phone:

Email address:

Organization:

Remote IP address:

Name:

Phone:

Email address:

Organization:

Remote IP address:

Name:

Phone:

Email address:

Organization:

Remote IP address:

Name:

Phone:

Email address:

Organization:

Remote IP address: