Video Conference Request Form

image of bird's eye view of group video conferencing

VTC's are FREE for Educational (Classes with students assigned) Events only.

Others will be charged (Please Fill Out the Billing Information At Bottom):
$ 35.00 per hour for USA calls
$150.00 per hour for ALL International calls.

Fields marked with * are required. Contact Stephen Zimmerman (2-4168) with problems.

MUSC Requestor Information

Requestor

E-mail address

Phone number

Faculty Name

Event/Course Title

# of People using room

MUSC Site Information

MUSC Room

If OTHER give room

Conference Type

AV Technician Needed

Remote Site Information

Remote Contact Name

Remote Contact Phone

Remote Contact E-mail

Date of Event(s)

From (Mo/Day/Year)

To (Mo/Day/Year)

Times (Must also add AM or PM)

Start time

End time

Additional Instructions: