For requesting satellite downlink (reception) services from Information Technology. Please call (502) 852-6090 if you need assistance completing this form.

Contact Name: (Required)

Tthe person who can be called with questions concerning the topic as well as the date and time.

Contact Email Address: (Required)

GWID: (Required)

Please enter your GroupWise/ULink ID (enter NONE if you haven't one)

Contact Department/Company: (Required)

Contact Telephone: (Required)

Departmental ELD: (Required)

This is required to contact program provider for information

Program Title: (Required)

Date & Time Needed: (Required)

MM/DD/YYYY HH:MM am/pm (NOTE: am/pm *must* be lowercase)

// :

End Time: (Required)

MM/DD/YYYY HH:MM am/pm (NOTE: am/pm *must* be lowercase)

// :

Satellite Band: (Required)

Please note that UofL can only receive Ku Band feeds that are analog (non-digital) and clear (non-encoded)

Unknown at this time Ku Band Only C Band Only Ku and C Bands

Campus: (Required)

Select Campus for Viewing Location

Building & Room: (Required)

Enter TBA if location not known yet

Expected Attendance: (Required)

Originating Program Contact:

Program Contact Telephone:

Program Web Site URL:

(if known)

Billing Contact: (Required)

name & phone

Billing Information: (Required)

Account Number/Authorized Name OR Complete Billing Address Required

Other Information:

Please enter any other information here

Satellite Conferencing Support Rates

Service/Item Description	Rate
Coordination Fee (nonrefundable)	$35
Communications Services Engineering Support (one hour minimum)	$50/hour
Ku Band Satellite Dish & Receiver Use (one hour minimum)	$15/hour

Please see the Media Support Rental Rates for the audiovisual equipment costs

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