Iowa Communications Network
Request for Confidential Session
Fax Form

Fax completed form to the ICN Network Service Center at (515) 323-4414.

This session is CONFIDENTIAL. I request that it not be viewed or monitored in any way, for any reason.

As the requester, I will notify participants that they should contact the ICN Classroom Operations Center at (515) 242-3182 to report any technical problems. (When using the fiber phone, dial 242-3182.)


Reservation #: ___________________________________

Date: ____________________________________________

Day of Week: _____________________________________

Start Time: ______________________________________

End Time: ________________________________________

Originate Site: __________________________________

Name of Requester: _______________________________

Phone: ___________________________________________

Agency: __________________________________________

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