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Video Gateway Service Request Form

For receiving a satellite broadcast, we suggest you contact WPSU-TV at 814-865-2604 for consultation before completing this form.

* = Required

Today’s date
*Contact Name
*Contact Phone
*Contact Email

Event Information

*Event Name
*Date
*Time

Please include your comments and suggestions below (optional):

Videoconference Receive Site

Campus 

Room  

Will other campuses be receiving this program? Yes No

List other locations by campus and room:  

Satellite Origination Information

Origination Site 

Contact Name  

Contact Phone  

Email  

Registration required Yes No

Other Information

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