Virtual Meeting Request Form

Virtual Meeting Information

NOTE: If webinar will occur on multiple dates, please describe in Comments section at the end of this form.

1. Proposed Date:

2. Alternate Date (if applicable):

3. Select a Start Time: (00:00 AM)

4. Select an End Time: (00:00 PM)

Time Zone:

NOTE: Most of Arizona does not observe Daylight Saving Time. From March to November, Arizona (outside of Navajo Nation) is aligned with Pacific time due to Daylight Saving Time. Navajo Nation follows Mountain time year round.

5. Title of Meeting

6. Short Description of Meeting

7. How Many Attendees do you need space for (i.e. virtual room size)? (Please Select one):

8. Will you need this to be recorded? (Please Select one):

9. This presentation is (Please Select one):

10. Do you need people to register beforehand or just a direct link to enter the meeting?:

11. Presenter or Organizer Contact Information

Presenter 1/Organizer Name:

Organization/IHS Department:

Email Address:

Phone Number:

Presenter 2 Name/Credentials:

Organization/IHS Department:

Email Address 2:

Phone Number 2:

12. Comments/Additional Information, or questions?