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Date of Conference:
*
Start Time:
*
End Time:
Conference Subject:
Conference Leader:
Presenting with a computer?
Will you be using a telehealth cart?
If Yes, add to "Additional Comments" section below.
Contact for Meeting:
Contact Phone Number:
*
Host Site:
Approximate Number of Participants at Host Site:
Conference Participants:
(Please select all that you will invite.)
Use Shift or Ctrl keys to select multiple values.
Participating Sites:
(Please select no more than 11 sites.)
Use Shift or Ctrl keys to select multiple values.
Additional Comments:
Your completed Video Conference Reservation Form will be emailed to Video Communications and Distance Learning. You will receive a confirmation email and they will set-up the conference for you.
If you have any questions, contact Sandra Blakely at (334)206-5635 or (334)206-5618. Thank you.
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