Video Conferencing Request Form

To request the use of video conferencing facilities at UW Tacoma, please complete the form below. We suggest you peruse the form first and gather all the required information before beginning.

Your request will be submitted directly to the Media Services help desk system, and within a few minutes you will be sent an email confirming that we have received your request. Be sure to check your spam filter if this email does not arrive. Please allow two business days for us to review your request and reply (via email) with a decision.

Note: required fields are marked with an asterisk (*).
Review and Finish
	Are your details correct? Please review before submitting. Click only ONCE. It may take a few seconds to process.
Requestor's Information (that's you)
*First Name
*Last Name
Dept/Org
*Phone	Ext.
*Email
*Confirm Email
UW NetID	(if you are affiliated with UW)
Billing Information (fees may not apply to UW faculty and staff)
Name
Address 1
Address 2
City
State
Zip Code
Phone	Ext.
Email
Event Information
*Event Title
Frequency	One-time Recurring
Preferred Event Date and Time
*Start Date	(MM/DD/YYYY) If recurring, enter the first date here. Provide subsequent dates and start/end times in comments.
*Start Time	hr 00 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 : min 00 05 10 15 20 25 30 35 40 45 50 55 (US Pacific time; 24-hour clock)
*End Time	hr 00 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 : min 00 05 10 15 20 25 30 35 40 45 50 55 (US Pacific time; 24-hour clock)
Comments
Alternate Event Date and Time (if your preferred choice is not available)
Start Date	(MM/DD/YYYY) If recurring, enter the first date here. Provide subsequent dates and start/end times in comments.
Start Time	hr 00 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 : min 00 05 10 15 20 25 30 35 40 45 50 55 (US Pacific time; 24-hour clock)
End Time	hr 00 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 : min 00 05 10 15 20 25 30 35 40 45 50 55 (US Pacific time; 24-hour clock)
Comments
UWT Site Information
*Participants	How many people are you expecting at UWT?
Room Choice	BHS 107 (seats 40 at classroom tables) MAT 352 (seats 20 at conference table)
Presentation Features Needed	Need to connect my laptop Document camera (for printed documents or transparencies) Projector and scan converter (for displaying computer screen) VHS playback DVD playback VHS recording of video conference (one copy only; charges apply)
Comments
Remote Site #1 Information
*Facility/ Institution
Connection Type	ISDN number: IP address:
*Conference Contact	*Name *Phone Ext. *Email
*Technical Contact	*Name *Phone Ext. *Email
Comments
Site #2	I need to enter information for another remote site.
Remote Site #2 Information
*Facility/ Institution
Connection Type	ISDN number: IP address:
*Conference Contact	*Name *Phone Ext. *Email
*Technical Contact	*Name *Phone Ext. *Email
Comments