Video Conferencing - Media Distribution Services

	Media Distribution Services
		C a l i f o r n i a P o l y t e c h n i c S t a t e U n i v e r s i t y

:: Video Conferencing Reservation Form ::

Use the following form to request a reservation for a video conferencing session.
For questions, please contact Eric Boege (805-756-6429) or eboege [at] calpoly [dot] edu.

Contact Information
Department:
Dept Billing Account #:
Contact Person:
Phone:
Fax:
E-mail:
Conference Details
Name of Conference:
Proposed Conference Date:
Conference Time:	until (Pacific time zone)
Number of People @ SLO (approx):
Type of Connection:
Who will initiate the call:
Special conference requirements, such as Multipoint, telephone bridge, recording, document camera or live streaming:
Far End Technical Contact Information
Tech Contact for Testing:
Tech's Email:
Tech's Phone:
Equipment Type: (Polycom, Tandberg, Kwangchung)
Type of Connection
IP Address:
ISDN Number:
Internet2 GDS address, if known	Example: 001189 7561234
Note: After clicking, be sure to follow the instructions on the next page to complete. Cancellation Policy: The cancellation of confirmed conference dates require 24 hours advance notice. There is a charge of 50% of the room reservation amount for cancellations with less than 24 hours notice. "No Shows" will be billed for the entire reservation amount.

Last Update: 02/22/2005

Media Distribution Services
California Polytechnic State University
Building 02, Room 09
San Luis Obispo, Ca 93407
805.756.7198
mds [at] calpoly [dot] edu