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University of Utah St. George Graduate Center
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Interactive Video Conferencing Form for Classes
Request a Video Conference Course Connection with St. George
Customer Contact Information
*Indicates a required field.
Requestor First Name
Requestor Last Name
University ID
Email
Course Information
Course Number(s) and Section(s)
(e.g. ED PS 6010-001/045)
Course Name
Semester
Fall 2019
Spring 2020
Summer 2020
Fall 2020
Instructor's Name
Instructor's Email
Instructor's Phone
(e.g. xxx-xxx-xxxx)
Class Dates
Full Semester
Other Dates
Start Date
End Date
Start Time
End Time
Repeats
Mondays
Tuesdays
Wednesdays
Thursdays
Fridays
Saturdays
Sundays
List each participating location with student count (e.g. SAEC 3151: 20 students, St. George: 8 students, Private residence: 2 students) *Note: it is your department’s responsibility to schedule each of these locations. This request form is for the video conferencing connection only.
Record the course?
Yes
No
Additional Information
Last Updated: 7/25/19
