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IT Classroom Support - Equipment Request Form

Use this form only when requesting equipment 24 hours in advance. When requesting equipment for same day use,
please call 455-6111 for availability.

Please do not submit on-line requests after 2:00 p.m. on Friday through 9:00 a.m. on Monday for Monday's equipment use.

Full Name:
 		Phone:
 		Email Address:
Department:
 		Campus:
 		Room:
Start & end dates are required
Start date:

End date:

Days:
Start Time:
End Time:

 
Audio Equipment: Camcorder:
Audiotape Player
Audiotape Recorder		 Video Camcorder
Blank Tape Length 

CD Player
Record Player
PolyCom Audio Conference

VHS
 VHS-C
S-VHS
 Mini DV
Blank Tape Length
Computer: Video Equipment:
PC/LCD Projector TV/VCR
PC(only) Laser Disk/TV
LCD Projector-only DVD/TV
Wireless Computer Cart Document Camera/TV
Interactive Whiteboard Other: (explain in notes)
Traditional AV: PA System:
Overhead Projector Amplifier & Speakers
with roll Boom Box
Slide Projector  Microphone   Qty.
  Carousel tray
Remote control		   Hand-held
Lapel Mic
    Microphone Stands:
    Table top
    Podium
    Floor stand

 Special Instructions and other types of equipment needs:

A Confirmation email will be sent to confirm that this request has been filled.