Vermont Interactive Television -- Reservation Request Form

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Vermont Interactive Television

Reservation Request Form

Complete the form below to send a Reservation request to the Scheduler.
*=Required Fields

First Name*	Last Name*

Organization

Address

Address

City	State	Zip

Country

Phone*	Fax

Email Address*

Event Title

Desired Date (mm/dd/yyyy) plus two alternatives

Desired Start Time (AM/PM-EST) plus two alternatives

Event Duration

Sites. (Check all desired.)

Origination Site	Non-VIT Sites:

Additional Comments