AV/Multimedia Equipment Request
Name
*
Email
*
Phone number
*
Type of employee
*
FT Faculty
Adjunct Faculty
Administration
Staff
Other
Date needed
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Time needed
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01
02
03
04
05
06
07
08
09
10
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00
15
30
45
AM
PM
Length of time needed - factor in setup, practice time, and actual event time.
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01
02
03
04
05
06
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09
10
11
12
00
15
30
45
Location (campus building name)
*
Main
Academic
Library
Student Union
Room/Classroom
*
Type of equipment requested
*
(Smart Cart):Laptop computer Portable projector)
TV with DVD/VCR player on a rolling cart
DVD video camera
Camcorder
Overhead projector
Slide projector
Portable DVD player (In Library Use Only)
CD/cassette player
Audio cassette player
Hold the Ctrl key to select multiple items.
Auxiliary items needed:
Projection screen (free standing)
Extension cord(s)
Tripod
3 ½" floppy disk
Computer mouse
Remote controls
Laser pointer
Estimated group size if requesting equipment setup in the Boardroom, Reception Hall, or the Lyceum in the Student Union.
*
Approximate time of completion.
*
01
02
03
04
05
06
07
08
09
10
11
12
00
15
30
45
AM
PM
Optional Information
*
Designates a required field.