University of Pittsburgh - CIDDE - Center for Instructional Development&DistanceEducation

University of Pittsburgh

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Non-Print Media Specialist

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Satellite Teleconferencing

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	QUICK LINKS
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	FORMS
-	Classrooms Feedback Form
-	Media Request Form
-	Repair Form
-	Satellite Request Form

Satellite Downlink Service Request

4227 Fifth Avenue (B-10 Alumni Hall), Pittsburgh, PA 15260
Tele: (412) 624-6918 or Fax: (412) 648-8812

Please provide all required information and submit the form to request audiovisual equipment and other media materials.

Name:

Telephone:

Today’s Date:

Address:

Department:

Name of satellite broadcast program:

Date of broadcast:

Start time:

End time:

Please verify: Start and end broadcast times are for the Eastern Time Zone. Yes:

Is a signal test broadcast scheduled?
Yes: No:

Time of test broadcast:

Do you wish to have this program recorded on video tape? Yes: No:

If yes, please initial here to verify you have copyright permission to record this program:

Do you wish to arrange a ‘live’ screening of this program? Yes: No:

Preferred site:

Number of attendees:

Have you arranged for refreshments though University Food Service? Yes: No:

Please note: Food and beverages are not permitted in Pitt classrooms.

Technical Information:

Satellite Name:

C Band:

Ku Band:

Transponder #:

Channel #:

Polarity:

Broadcast Frequency:

MHz Audio:

Backup Satellite Name:

C Band:

Ku Band:

Transponder #:

Channel #:

Polarity:

Broadcast Frequency:

MHz Audio:

Broadcast telephone help number:

Signature:

Your signature is not required if submitting this form via e-mail. Include your signature only if you fax this form to Instructional Media Services.

E-Mail:

If you are submitting this form via e-mail you must include your email (user name)

CIDDE USE ONLY: Job Number ____________

Center for Instructional Development & Distance Education