LTLI - Long Term Living Training Institute Of Pennsylvania

Video Conference Request Form

Video Conference Form Instructions:

Choose the time and date you wish to have the video conference (Alternate Time is optional)
Provide a title, brief description, and target audience for the video conference.
Fill out requestor information (this is the person filling out the form). If requesting on behalf of another staff member, click the appropriate box. This will bring down a drop down menu for the additional contact. Complete this information.
Click the Yes button next to the video conference locations. This will bring down pull down menus. Select one location. For each location you select, you will be prompted with a new blank pull down menu. Select as many sites as you wish to have on your conference.
If you want to have incorporated content, select the Yes button next to the Content category. Select the number of files you are going to use and a brief description (title will suffice) of the files. If you do not know how many files you'll have at first, just select Other and describe them as "Additional files to be provided"
If you want the video conference to be recorded, click yes. You will not be prompted for anything else.
If you want the video conference streamed, click yes. You will be prompted to provide the number of streams you like.
Review the terms of the bridging request.
Type the appropriate words into the recaptcha security box and click Submit Form.

Once your form is received it will be reviewed and you will be contacted regarding any changes that need to be made. You will not need to resubmit another form for each change. For instance, if a site is not available you will not need to resubmit a form. P4A/LTLTI will complete a final confirmation form once everything has been confirmed and scheduled. This will just be for our records. Please keep in mind that a video conference is tentative until confirmed by P4A-LTLTI as we may need additional information from the requestor to complete the scheduling process. Confirmation is received via an MS Outlook Appointment to be accepted by the requestor.

Contact Information

Current Date: 02/04/12

Requested Date:

Requested Time: : until :

Alternate Time: : until :

Video Conference Title:

Please provide a brief description of this video conference:

Please identify the target audience for this video conference:

Requestor Contact Information

First Name:

Last Name:

Organization:

Phone: - -

Email:

Are you requesting this video conference on behalf of another staff member
or organization? Yes

On behalf of: Please Provide Full Name

Organization:

Phone: - -

Email:

Video Conference Locations

Please select the locations that will participate in the requested video conference. Yes

Other:

Video Conference Settings

Preregistration allows for video conference participants to sign up for the video conference prior to the scheduled date rather than at the start of the video conference. It also allows for the Requestor to receive a list of of all participants who have signed up to attend the video conference.

Password ? Yes

Presentation Content

Will you have any content files to incorporate into the presentation via the video conference (PowerPoint, Word, Web Pages, etc.): Yes

Please choose the amount of files you will be using for your presentation

Files Type File Description

Recorded

Would you like this video conference to be recorded? Yes

Streaming

Streaming allows for a real-time broadcast of the video conference to be sent via hyperlink for a viewer to watch on their computer. The link for the video conference is emailed to the requestor the day of the conference and can be forwarded to any prospective viewers via email. Would you like to receive any streaming links (50 max)? Yes

Terms

Notice: A minimum of two weeks notice is required for all Video Conference Bridging requests. Additional scheduling time may be required depending on the size of the video conference.

Locations: Participation in the requested video conference is at the discretion and availability of the location. The requestor will be contacted if one or more locations are unable to attend. Please allow additional scheduling time for locations not within the LTLTI Wide Area Network.

Attendance: Attendance sheets must be submitted to LTLTI for each location involved in the video conference.

Recording: LTLTI will provide (1) copy of the video conference on CD-ROM, to be mailed to the Requestor Organization. LTLTI is also able to store video conferences on an archive server and provide access links at any given time to the Requestor.

Fees: Depending on your organization, fees may apply for Video Conference Bridging services. To obtain a quote for a prospective video conference please contact rob@ltltrainingpa.org

Approval: Video Conference Bridging services are confirmed by LTLTI prior to scheduling. Submission of a Video Conference Bridging Request Form does not guarantee confirmation of scheduled services.

I agree with the Terms mentioned above and am ready to submit the Video Conference Request Form.

Please contact Rob Wierman at rwierman@ltltrainingpa.org with any questions