Interactive Television Request Form

Interactive Television Request Form
Meeting Requester:
Requester's E-Mail :
Requester's Phone number :
Meeting Title :
Meeting Date : (MM/DD/YY)
*option for re-occurring meeting dates
Enter additional dates
Meeting start time : (HH:MM am/pm)
Meeting length : (HH:MM)
Number attending WSU : (##)
Number attending Remote site : (##)
If requesting remote site other then Rochester Please list:
Preferred WSU room :
*Requested rooms are subjected to availability Somsen 322 Somsen 110 Phelps 101 Stark 105 Stark 303
Please provide and further information needed :