Emerging Technology Center

Scheduling Request

*required fields are denoted with an asterisk

Technology Information:
What type of equipment/medium are you requesting?*:

Preferred GSU location:
-Unless otherwise requested, all conferences will be held on the GSU campus.

Contact Information:
Name*: Email*:

Phone*: Fax:

Program or conference description*:


Contact @ GSU: Phone:

Conference Information:
Date of conference*: , ,

Start Time*: End Time*:

Expected Attendance:

Facilitator Needed*:   yes no
-The rate for having a facilitator is $10.00/hr. If you choose not to have one, there will be no one present during the conference to oversee everything. Other charges may apply.

Other sites involved in the conference* (if applicable):

Site 1: This site is the host site:
Contact Person: Phone:

Site 2: This site is the host site:
Contact Person: Phone:

Other sites:

Additional Comments:


Please note: This is a scheduling request. You will be contacted with confirmation or denial information, including the Georgia Southern room the conference will be held in.