University of Kentucky Webcast Center

Live Webcast - Application Form
In order to be considered as a webcast institution, please complete all sections fully, otherwise we will not be able to process your form.
Contact Person

First Name:
Last Name:
Organization:
Website:
Address 1:
Address 2:
Zip:
City:
State:
Country:
Country code:
Phone Number:
Fax Number:
E-mail (required):

Event Information

What content are you able to provide? (check all that apply)
Live Surgery
Video Commentary
Lectures
Grand Rounds
Medical Meetings
CME courses
Resident Rounds
Other
How often can you provide content?
 
How long will your event last?
 
According to US Estearn Standard Time (EST) zone, your event is likely to occur:
 
English Language Competence

Connectivity and set up Information

What type of connectivity does your Institution have? (check all that apply)

ISDN 68 kbps
ISDN 128 Kbps
ISDN 256 Kbps
ISDN 384 Kbps
ISDN 512 Kbps
 ISDN 768 Kbps
T1
IP (fast Internet)
Dial up (56 kbps)
I don't know
 
What kind of Video Conference System do you have?
(provide as much information as you can)

Other Information
Please add your questions or comments
 

By Submitting this form, you are certifying that the information provided above is accurate and complete. The University of Kentucky Webcast reserves the right to cancel the event without notice and indemnity. This form is an application only: completion does not guarantee that your event will be broadacast

You will be contacted by our program coordinator, Jim Goodpaster witinin 48 hours to discuss broadcast opportunities further.

 
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