Video Conference Request Form

More info

Hours are 8 a.m. - 5 p.m., Monday - Friday. Check calendar for availability. A minimum of two business days is required; however, for international conferences, five business days is preferred. After-hour conferences require a minimum of three business days. Only two-way video and audio services will be provided unless otherwise noted. Canceling scheduled conferences less than one full business day prior to the conference, as well as "no-shows," will incur normal charges.

Call (573)882-2000 if you have special circumstances or if you need assistance filling out this form. Be sure to have the appropriate technical information. Required fields are shown in red. All times are Central Time.

Requestor/originating site information
Request date:
Requestor name/local participant:
Department/organization:
Requestor phone number:
Requestor e-mail:
Conference date:
Conference time:	to
Conference purpose:	(Include number of local participants)
Special instructions:
Video system:
Most conferences will use H.323-SD (standard definition). Only select H.323-HD (high definition) or AGN if the remote sites are compatible. If you select AGN, provide venue name/virtual room under special instructions.
Remote conference site information For AGN conferences, provide information for at least one site.
First participating site:
Participant contact:
Participant contact phone:
Participant contact e-mail:
Technical contact:
Technical contact phone:
Technical contact e-mail:
Second participating site:
Participant contact:
Participant contact phone:
Participant contact e-mail:
Technical contact:
Technical contact phone:
Technical contact e-mail:
Third participating site:
Participant contact:
Participant contact phone:
Participant contact e-mail:
Technical contact:
Technical contact phone:
Technical contact e-mail:
Fourth participating site:
Participant contact:
Participant contact phone:
Participant contact e-mail:
Technical contact:
Technical contact phone:
Technical contact e-mail:
Fifth participating site:
Participant contact:
Participant contact phone:
Participant contact e-mail:
Technical contact:
Technical contact phone:
Technical contact e-mail:
Billing information
MoCode:
Authorized signer:
Campus address:
Campus phone:
General comments:

University of Missouri
Division of Information Technology
615 Locust Street, Columbia, MO 65211
(573)882-2000