Requesting Institution Information Date Submitted Title of Class/Event Test Requested By Institution Phone Email Date of Planned Event Time Zone Time(USA-Central Time) International-Greenwich Start Time End Time Tip: Type 'A' or 'P' to switch AM/PM Off-Network Site Information Name of Site City/State/Country Technical/Videoconference Contact Name Phone E-Mail Room Name/No. Room Phone H.323 IP Address ISDN (if ISDN)Phone Is there a Firewall...??? YesNo Any dates/times that would be best for testing: Comments: