Wufoo
Maine Distance Learning Centers Usage Request
Audio, Classroom, Video Tele-Conferencing (VTC)
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For Assistance Contact:
David Nichols, 430-6529, david.m.nichols3.nfg@mail.mil (Bangor, ME)
Jeff Rich, 430-5853, jeffrey.a.rich8.mil@mail.mil (Augusta, ME)
Thomas Neill, 430-6151, thomas.j.neill6.mil@mail.mil (Bangor RTI)
James Coppenger, 430-5486, james.e.coppenger.mil@mail.mil (Lewiston)
Type of Request:
NEW
UPDATE
CANCELLATION
Type of Resource:
*
Audio
Classroom
Video Teleconference (VTC)
Preferred bridge type
*
Meet-Me
On-Demand
Number of Lines for Audio:
Number of Personnel Per Event/Day:
Attach an Alpha Roster
Requesting Unit:
*
Event POC:
*
POC Phone Number:
*
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POC Email:
*
Event/Conference Name:
*
Purpose: Select Best Fit:
*
Select Best Fit
Command & Control C2
Collective Training
Individual Training
Recruiting & Retention
Soldier & Family Support
Testing
Other Specify in Comments
Start Date
*
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YYYY
End Date
*
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DD
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YYYY
Start Time:
*
HH
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SS
AM
PM
AM/PM
End Time
*
HH
:
MM
:
SS
AM
PM
AM/PM
Additional Dates
1
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YYYY
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3
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4
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11
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Locations: (Check All That Apply)
*
Augusta DL
Bangor AFRC DL
Bangor 240th RTI
Lewiston DL
Other Location
Comments: Provide additional info.
Rating: How easy is this form?
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Wufoo
Designed