Educational Technology

Media Equipment Use Request Form

(For Academic Use Only)

Please review the Media Equipment Management Policy to understand the procedures involving equipment use and training requests and to ensure proper use of equipment.

To request audio and video equipment, please complete the form below. We will contact you to confirm availability.

Requestor Information:

Name   
Phone
Email
Department

 Check the equipment you are requesting:

Camcorder LCD Projector
Cassette Recorder Overhead Projector
CD Player Presentation Navigator
Digital Camera Projection Screen
Digital Voice Recorder Slide Projector
DVD Player Smartboard Wireless Slate
ELMO Digital Projector Tripod
Extension Cord VCR
Laptop Computer Wireless Mouse
Laptop Computer and LCD Projector  

Other Equipment (Please explain)

Intended Time of Use:
Date(s):    to   
Time: From (e.g., 10 a.m.)  To   
Service Location:
Building:
Room:
Other Location:
Additional Information: