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Video Conference Request Form

Conference Booking Contact
Format: (xxx) xxx-xxxx
Format: (xxx) xxx-xxxx
Conference Details
Please note this is only a request. Your requested date and time must be confirmed by APSU before the booking is final.
:
Clarksville is in the Central Time Zone. The time entered here is assumed to be Central Time.
:
Clarksville is in the Central Time Zone. The time entered here is assumed to be Central Time.
(You may have a videographer, etc. who needs preparation time.)
(Set-up time will be billed at a rate of $62.50 per hour.)
(e.g., interview, deposition, etc.)
Requested room location must be confirmed with an APSU representative.
Technical Contact
This individual will work directly with the APSU technician to arrange a test call and handle technical issues during the conference.
Format: (xxx) xxx-xxxx
Format: (xxx) xxx-xxxx
Example: 25.34.23.100
Billing Contact & Details
Format: (xxx) xxx-xxxx
Format: (xxx) xxx-xxxx
Invoices are issued via email to the billing contact noted in this request form following completion of the video conference. Payment is due 30 days from date of invoice. If you prefer that an invoice be mailed to you, please provide a complete mailing address here. If you have elected to pay via a credit card, please contact our office directly at 931-221-7816.