Penn State New Kensington LogoMEDIA SERVICES - REQUEST FORM

Submit Issue to NK Media
** Mandatory fields are highlighted and preceded by an asterisk

*Title:      Priority:

Issue Information
Requests must be received no less than five (5) business days prior to the start date. Requests that require Media Services staff to be present for the duration of the event must be submitted ten (10) business days prior to the start date. Requests made in less than the required advance notice are not guaranteed and request completion will depend upon the availability of the Media Services Staff. To see what equipment is available, what is installed in each room, and to review our policies, guidelines, and tips, please visit the Media Services Website. 

*Request Type:        
*Department:
*Start Date (Example: 03/22/2011):
MM/DD/YYYY
*Start Time (Example: 10:00 AM):
*End Date (Example: 03/22/2011):
MM/DD/YYYY
*End Time (Example: 10:50 AM):
Reoccurence Pattern (Hold CTRL to select multiple):
Additional Assistance (Hold CTRL to select multiple):
*Building and Room:
Equipment (Hold CTRL to select multiple):

(Photos of media equipment)
POLYCOM ONLY

*Preferred Room:
*Estimated Attendance:
* Will more than two campuses be joining this meeting?
* Or is a Video Bridge reservation needed?
Who is hosting this meeting?
If Penn State New Kensington is hosting the meeting, Media Services must fill out a Bridge Request
Form which goes to University Park. UP requires 5 days to process this request. Requests recieved
with less than 5 days notice might not be fulfilled. More information can be found at:
The Penn State Video Bridge 
   
If "Other Campus", which one?:
Remote Site(s) Name(s):
(Include one campus, building and room per line)
 
Preferred Conference Mode: Image of Conference Modes



Contact Information

*Last Name:
*First Name:
*Email Address:
*Phone: (Example: 724-334-6081)

Description/Comments
Use this field to capture any important information that was not captured in the above fields.




 
Click the SUBMIT button to send your Request. You will receive an email confirmation if your Request is successfully registered. There is no need to reply to this email.
Be sure to click the submit button only once. A separate Issue will be entered each time the button is clicked.
Suggestions or problems with this form? Please e-mail Kevin Churik krc5016@psu.edu