| U of C Contact: |
| Last Name:* |
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First Name:*
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| Contact Phone:* |
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Contact Fax: |
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| Department: |
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Email Address:*
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| Date: |
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Remote Contact: |
| Last Name:* |
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First Name:* |
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| Department: |
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Telephone:* |
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| Email Address:* |
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Fax: |
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Authorized Signer Information*: |
| Last Name:* |
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First Name:*
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| Telephone:* |
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Email Address:*
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| *FAS Account #: |
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Billing Information The University of Chicago will bill to FAS accounts only. If the remote contact would like to pay for the call, the University of Chicago contact will have to get reimbursed on his or her own. Please contact your department to make these arrangements. |
Rates (per hour): |
| Local call, point to point |
$80.00 |
| Long distance call, point to point |
$80.00 |
| International call, point to point |
$80.00 plus usage fee (rates vary depending on country. Please contact Integrated Client Services & Support at 2-9100, option 4 for an exact rate) |
Local or long distance multi-point call |
$80.00 per location |
| International multi-point call |
$80.00 per location plus usage fees (rates vary by country) |
| Cancellation/rescheduling fees |
All cancellations will need to be submitted days prior to the scheduled videoconference or the following fees will apply: Three days before schedule date: $
Same day as scheduled date: $
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| Please note: The customer will pay for the entire time that the room is reserved, even if the video conference ends early. |
Call Type* (choose one) |
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| *Requested date for video conference: |
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| *Requested time for video conference: |
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| Duration of conference: |
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Speed of the call: |
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Who will originate the call? U of C contact Remote contact
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| Please provide the phone number to be called:* |
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| If U of C will receive, our phone number is 773-752-3860. |
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Will you need a PC set up for the conference? yes no
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| Important:
Host/Hostess must arrive at least 45 minutes to one hour before the conference begins to obtain brief instructions for the video conference equipment and to set up any other equipment (e.g. laptop, slide projector). ALL participants must arrive at least 15 minutes before the conference starts.
Further inquiries may be directed to 29100@uchicago.edu, fax 773.702.4457, or to speak to Integrated Client Services & Support , call 773.702.9100, option 4.
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Last updated: 6/26/08