Audio/Video Support Request

Request A/V Conferencing and Live Event Support

If you would like to request an Ambient technician to operate your conference or live event, or provide equipment, please complete the following form:

RESERVATIONS MUST BE MADE AT LEAST 24 HOURS IN ADVANCE

CONTACT INFORMATION

Cost Center #: (required)

Lifespan Department: (required)

Your Name: (required)

Street Addresss: (required)

City: (required)

State/Province: (required)

Zip/Postal Code:

Email: (required)

Phone: (required)

TYPE OF EVENT OR CONRFERENCE: (please select one)
ConferenceEventOther

EVENT INFORMATION:
Date of Event: (required)
Start Time of Event: (required)
End Time of Event: (required)
Host Location: (required)

CONFERENCE INFORMATION:
Will computer images, like Powerpoint presentations, need to be viewed by the audience?
YesNo
Will the Presenter be using their own computer? (NOTE: If using a MAC, you will need to bring your VGA adapter)
YesNo

Additional Comments/Requests (such as extra microphones, etc.)

TO SCHEDULE VIDEOCONFERENCING SERVICES
Please go to your Lifespan Intranet, click the "Administrative Tab," then select "Telecommunications" under the "Departments" list and click "Teleconference Services"

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