Name of Supplier:

Name of Presenter:

Webinar Date Requested:

Time of Webinar (EST):

Length of Presentation:

Will this Webinar be recorded by OSSN for future playbacks?
Yes No

Agenda To Be Displayed (5 lines or less):

Name of your Topic:

Will presenter be using a PowerPoint presentation?
Yes No

Will presenter be using an internet web site for this presentation?
Yes No

Is presenter familiar with how to use WebEx technology?
Yes No

Presenter Phone Contact:

Presenter E-mail address:

OSSN will use this E-mail address to reconfirm your Webinar meeting.

Other requirements:

• Presenter must have high speed internet access
• Presenter must call OSSN Webinar Coordinator 20 minutes prior to meeting at 800 771 7327
• WebEx requires a “plug in” install program on the PC you are using. Please make sure your firewall allows this simple one minute download.