Video Conferencing Request Form

Please allow at least a week notice for scheduling a videoconference at the School of Education. The requestor should have already booked a room in the SEB and made an initial booking contact with the other site(s). Items with a red "*"on the form are required.

Requestor Contact & Billing Information

* Your Name:
IMPORTANT: this service is only for SOE faculty, staff, and students.
YOU MUST HAVE A UMICH.EDU EMAIL ACCOUNT FOR THIS TO WORK.

* Email address:

* Your Phone Number:
(full address needed: e.g., user@umich.edu)

Charging Shortcode:

Authorized Signor:

Event Info

* Event Date:

Month

Day

Year

* Event Start Time: (Eastern Time)

* Event End Time: (Eastern Time)

* Set Up Time: (Minimum 30 minutes before event)

* Event Location: (You Must Reserve A Room Yourself)

# of Participants at SEB:

Do you want a videotape of the event? Yes

Who will initiate the connection?
< - SOE <- Far site 1

Far Site

* Lead Participant:

* Lead Email:
(Full address, e.g. user@umich.edu)

* Lead Phone:

* Technical Contact:

* Technical Contact Email:
(Full address, e.g. user@umich.edu)

* Technical Contact Phone: