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                                                           Video conference Test Request

                                                            3 business day notice is required.
Conference Name/Course Number & Title

(Required Field)

Reservation Confirmation Number    
(Located at the top of the original confirmation email)

Site Information
Site Name
Tech Contact Name  (Required Field)
Email  (Required Field)
A value is required.Invalid format.
Telephone #  (Required Field)
A value is required.Invalid format.
Cell/Pager #
Invalid format.
Fax #
Invalid format.
Conference Information

Conference Type  (Required Field)
Video Conference
RealPresence Desktop Conference


Connection Type  (Required Field)
IP No.
ISDN No.


Video Conferencing Tests are Scheduled Monday - Friday 11 AM to 3 PM CST
A 3 business day notice is required.


Select Date/Time:                                  


Notes: