ALABAMA DEPARTMENT of PUBLIC HEALTH
 
Video Conference Reservation Form

Date of Conference:

* Start Time:


* End Time:


Conference Subject:

Conference Leader:

Presenting with a computer?

Yes No

Contact for Meeting:

Contact Phone Number:

* Host Site:


Approximate Number of Participants at Host Site:


Conference Participants:
(Please select all that you will invite.)


Use Shift or Ctrl keys to select multiple values.

Participating Sites:
(Please select no more than 11 sites.)


Use Shift or Ctrl keys to select multiple values.

Additional Comments:

Your completed Video Conference Reservation Form will be emailed to Video Communications and Distance Learning. You will receive a confirmation email and they will set-up the conference for you.

If you have any questions, contact Sandra Blakely at (334)206-5635 or (334)206-5618. Thank you.



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Alabama Department of Public Health