User Information Requestor: Email Address: Phone: Fax: Faculty/Staff: Email Address: Phone: Fax:   Event (There is a fee for all NON - Distant Educational Events)   $35.00 per hour IP Call/$50.00 per hour ISDN/$150.00 per hour ALL International calls Event/Course Title/No.: This is (a): [select type] New Change Cancellation Local Site: [select room] Basic Science 202 - Mac Only/Laptop Connection Available We No Longer Book CON220 (Contact Yolanda Long 2-3815) Other If OTHER Give Local Site(s): # of People Using Room Conference Type: [select type] IP - No Fee for Distant Education IP - Fee For Non-Educational Event ISDN - No Fee for Distant Education ISDN - Fee For Non-Educational Event Technician Needed: [select type] NO YES with No Fee for INITIAL SETUP ONLY YES with $30.00 per hour fee YES with $45.00 per hour fee/after hours Who Will Be Presenting: [select type] US - MUSC THEM - The Distant Site BOTH - MUSC and The Distant Site Sort of Presentation: [select type] Discussion Only Powerpoint BOTH - Discussion and Powerpoint Other   Billing Information (This is for NON - Distant Educational Events ONLY)   $35.00 per hour IP Call/$50.00 per hour ISDN/$150.00 per hour ALL International calls Company Name/ Department: Attention: Billing Address: Billing Address: City: State: Zip Code:   Remote Site Point of Contact 1 Site Name Site Phone Site Email ISDN #1: ISDN #2: IP Address: 2 Site Name Site Phone Site Email ISDN #1: ISDN #2: IP Address 3 Site Name Site Phone Site Email ISDN #1: ISDN #2: IP Address:   Days Of The Week   DE Rooms require 30 minute breaks between classes. Classes will not be booked back to back.   Date(s) Time(s)   From To From To Sunday Monday Tuesday Wednesday Thursday Friday Saturday   Equipment 35mm Slides DocCam DVD VCR Mac (BSB202) PC (CON220) Network Internet Excel PowerPoint Access Word Fax