Penn State New Kensington LogoINSTRUCTIONAL TECHNOLOGY - REQUEST FORM

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*Course Name: *Course Number:  *Section Number:
Request Information

Please allow a minimum of two (2) business days for completion of all requests. We will try to accommodate requests as soon as possible within the constraints of the current workload. Requests with larger scopes may require more than two (2) days to complete.

         
*Days of Class: MondayTuesdayWednesdayThursdayFridaySaturdaySunday      
             
*Start Date of Class:
Mon Day Year
 
*End Date of Class:
Mon Day Year
   
             
*Start Time of Class:
  
*End Time of Class:
     
         
*Estimated Class Size:
*Technology Needed for Class:
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multiples)
 
      If a special set-up is needed, please submit Maintenance Work Request to Business Office. For Media Support, please submit a Media Request.
Contact Information
*Last Name:
*First Name:
*Email Address:
*Phone: (Example: 724-334-6081)

Additional Class details





 
Click the SUBMIT button to send your Request. There is no need to reply to this email. You will receive an email confirmation if your Request is successfully registered. Please contact krc5016@psu.edu if you experience problems using this form. Be sure to click the submit button only once. A separate Issue will be entered each time the button is clicked.