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Videoconferencing Request Form 
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Videoconference Reservation Form (954-262-4964)
Please complete all sections ten days prior to the class start date.
Please choose a Location(s):

 
*Center or Program:
*Contact Person:
*Phone Number:
*Email Address:

PLEASE READ: By completing the Contact Person and E-Mail boxes, you will be the sole person we contact regarding this Videoconference request. Please coordinate all software installs and hardware requirements with the Videoconferece staff.

Once confirmation is issued every effort is made to avoid disruption to students and faculty. However it may be necessary to move a class from an assigned room to another room for one or more sessions. Please make sure to fill in all required fields to ensure proper processing.
Section A - Information:

Special Instructions or Comments:
-Please indicate a Videoconference Site/Campus and/or Videoconference Room preference. 
-Note: Request of preference will not guarantee the availablity of the requested room or site.

Course Number:
Course Title:
Instructor:
Phone:
Email:
Days Requested:
Number of Sessions:
Begin Date:
End Date:
Begin Time:
End Time:
Number of Participants:
ADA / Special Needs:

Special Instructions or Comments:   Please indicate a Computer Lab Site or Campus preference. We will do our best to place your class in this location; however, we cannot guarantee availability.
Comments:
Section B - Equipment for Classes
Select Equipment:
Other Equipment:
 | Nova Southeastern University | Contact Computing Facilities | Revised: February 15, 2008