JUVENILE COURT DEPARTMENT
VIDEOCONFERENCING AVAILABILITY FORM
Please attach a copy of this form to the motion requesting the use of videoconferencing equipment
Name of Requestor:
Title of Requestor:
Address:
Telephone Number: Date of Request:
Case Name: Docket No.
Court Location:
Date of Videoconference:
Time of Videoconference: a.m. p.m. Estimated Length of Use:
Location:
Name of Videoconferencing Liaison/Contact Person:
Telephone Number:
AVAILABLE NOT AVAILABLE
By Videoconferencing Liaison: Date:
Juvenile Court Matter: Trial Pre-Trial Conference
Other:
(check one)
To Be Completed by Requesting Party
REQUESTOR INFORMATION
VIDEOCONFERENCING DETAILS
REMOTE SITE DETAILS
To Be Completed by Videoconferencing Liaison
REQUEST FOR USE OF VIDEOCONFERENCING EQUIPMENT
JV-143 (04/28/2015)