SUBMIT TO:
CENTER FOR INSTRUCTIONAL TECHNOLOGY
AND DISTANCE LEARNING
P.O. BOX 10167 1014 Wyly Tower
RUSTON, LA 71272 citdl@latech.edu INTRA-CAMPUS MAIL - BOX 49
Date of Request:
College and Department:
Business or Corporation:
Request made by:
Address:
Telephone Number:
E-mail:
Session Name:
First Choice Date of Compressed Videoconference:
Time:Second Choice Date of Compressed Videoconference:
Time:Participating Sites:
Is this program event sponsored by grant funds? Yes No
NOTE: This form must be received by the Center for Instructional Technology and Distance Learning no later than five working days before the requested session/event date at the above address or at Campus Box 26. If you have any questions, please contact Kathy Caraway or David Cargill at 257-2912 or e-mail citdl@latech.edu.