Please provide as much information as possible.
Required fields are marked with an asterik.
 	Local Contact Info 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Far End Contact Info 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Event Details 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	
   	Please provide your contact information 	
 	 	First Name: * 	 	
 	 	First Name 	
 	 	Last Name: * 	 	
 	 	Email Address: * 	 	
 	 	Phone Number: * 	 	
 	 	Department: * 	 	
 	 	Affiliation: * 	 	 	  	 	 	
 	 	 Faculty 	
 	 	 Staff 	
 	 	 Student 	
 	 	 Other 	
 	 	Please provide the contact informationfor the far end of the confrenece  	
 	 	First Name:  	 	
 	 	First Name 	
 	 	Last Name:  	 	
 	 	Email Address:  	 	
 	 	Phone Number:  	 	
 	 	University or Business name:  	 	
 	 	Technical Contact?:  	 	 	  	 	 	
 	 	 yes 	
 	 	 no 	
 	 	 not sure 	
 	 	Is this person the technical contact? 	
 	 	IP Address:  	 	
 	 	Enter the far ends IP address if you know it 	
 	 	SAS Course #:  	 	
 	 	If this is realted to a SAS class please provide the course # 	
 	 	Date of conference : * 	 	 	
 	 	 	 	Month 	 	Jan 	 	Feb 	 	Mar 	 	Apr 	 	May 	 	Jun 	 	Jul 	 	Aug 	 	Sep 	 	Oct 	 	Nov 	 	Dec 	
 	 	 	 	Day 	 	1 	 	2 	 	3 	 	4 	 	5 	 	6 	 	7 	 	8 	 	9 	 	10 	 	11 	 	12 	 	13 	 	14 	 	15 	 	16 	 	17 	 	18 	 	19 	 	20 	 	21 	 	22 	 	23 	 	24 	 	25 	 	26 	 	27 	 	28 	 	29 	 	30 	 	31 	
 	 	 	 	Year 	 	2008 	 	2009 	 	2010 	
 	 	End time of conference: * 	 	 	 	 	
 	 	 	 	hour 	 	1 	 	2 	 	3 	 	4 	 	5 	 	6 	 	7 	 	8 	 	9 	 	10 	 	11 	 	12 	
 	: 	 	 	 	minute 	 	00 	 	01 	 	02 	 	03 	 	04 	 	05 	 	06 	 	07 	 	08 	 	09 	 	10 	 	11 	 	12 	 	13 	 	14 	 	15 	 	16 	 	17 	 	18 	 	19 	 	20 	 	21 	 	22 	 	23 	 	24 	 	25 	 	26 	 	27 	 	28 	 	29 	 	30 	 	31 	 	32 	 	33 	 	34 	 	35 	 	36 	 	37 	 	38 	 	39 	 	40 	 	41 	 	42 	 	43 	 	44 	 	45 	 	46 	 	47 	 	48 	 	49 	 	50 	 	51 	 	52 	 	53 	 	54 	 	55 	 	56 	 	57 	 	58 	 	59 	
 	 	 am 	
 	 	 pm 	
 	 	Start time of conference: * 	 	 	 	 	
 	 	 	 	hour 	 	1 	 	2 	 	3 	 	4 	 	5 	 	6 	 	7 	 	8 	 	9 	 	10 	 	11 	 	12 	
 	: 	 	 	 	minute 	 	00 	 	01 	 	02 	 	03 	 	04 	 	05 	 	06 	 	07 	 	08 	 	09 	 	10 	 	11 	 	12 	 	13 	 	14 	 	15 	 	16 	 	17 	 	18 	 	19 	 	20 	 	21 	 	22 	 	23 	 	24 	 	25 	 	26 	 	27 	 	28 	 	29 	 	30 	 	31 	 	32 	 	33 	 	34 	 	35 	 	36 	 	37 	 	38 	 	39 	 	40 	 	41 	 	42 	 	43 	 	44 	 	45 	 	46 	 	47 	 	48 	 	49 	 	50 	 	51 	 	52 	 	53 	 	54 	 	55 	 	56 	 	57 	 	58 	 	59 	
 	 	 am 	
 	 	 pm 	
 	 	Location: * 	 	 	  	 	 	
 	 	 MMS Studio (Capcity: 8) 	
 	 	 Multi-Media Resource Room  (Capcity: 2) 	
 	 	 Other (please provide your prefered location) 	
 	 	Other location building:  	 	
 	 	If you selected other, please provide the building 	
 	 	Other location room:  	 	
 	 	If you selected other, please provide the room # 	
 	 	Connection Type: * 	 	 	  	 	 	
 	 	 IP 	
 	 	 Skype 	
 	 	 iChat 	
 	 	 ISDN 	
 	 	 Not Sure 	
 	 	 Other 	
 	 	Expected Audience size locally :  	 	
 	 	Addition Details:  	 	
 	

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