Video Conference Event Request

*Required Fields


Contact Information

*Requested by:

*Requestor Phone:

*Requestor Email: 

Event Information

*Event Title:

*Start Date:  Calendar
*
End Date: Calendar

*Start Time (actual):  AM PM CT
*End Time (actual): AM PM CT

if Recurring... Weekly, select day(s) of the week
M   Tu   W  Th  Sa  Su 

Video Services starts sets up, including connection, 30 minutes prior to start time.

Event Description/additional scheduling information (excluded dates, special dates, etc.)

UNMC/TNMC Location

Video Services will assist in scheduling the appropriate location if needed. If scheduling your own room, please schedule the room 15-30 minutes prior to actual start time.

*Please select: I have reserved a room or I need a room

Number of anticipated campus attendees:

Requested Services

Descriptions of Technologies for Videoconferencing

Video conferencing to other site(s)

Live One-way Streaming to Web Viewers

Archiving to UNMC Server (Archives are created in Real Media and pushed to a folder on the UNMC Server)

URL (if known):

DVD Recording
There will be charges for DVD recordings. Please provide payment information

Cost Center Number/alternative Payment information:
DVD will be picked up DVD will be mailed (provide address with zip code, if different from contact information)

Computer Information

Presenting a Power Point Presentation

Bringing your own Laptop (If Mac, bring your adapter)

Video Conference Details

Telehealth Consult (distance sites must have encrytption capabilities)

Meeting

Lecture

Image of Text Type the text on the left
into the space below.

Visual Help...       Why...

 

Form last updated 01/28/14