Audiovisual Equipment Delivery Request
E-mail
Contact Person
Department

If department is not listed
(please specify)

Campus Address
Campus Zip
Phone
FAX

Instructor/person in charge
Deliver to room: on
Delivery Date

  at time :

  (MM-DD-YY)
Pick-up from room: on
Pick-up Date   at time :
  (MM-DD-YY)
Building
If other, describe:
Audience
If other, describe:
Audiovisual Equpment Requested
Video Units 1/2 VHS playback
1/2" VHS recording unit/camera
Slide Projection (35mm /2"x2") Carousel projector with carousel
Ringmaster (self contained slide/tape unit with screen)
Other Projectors Overhead (transparency)
Audiocassette Units Recorder/Playback
Computer Projection Devices
LCD Data Projector
Laptop
    Mac PC
Other

Portable cart
Portable sound lectern
Portable projection screen
Lasar pointer

ARS (audience response system)

1) A 2 day advance notice is required for ARS.
2) If a projectionist is need a projectionist form must accompany this form.

Other, please specify

Fund
Organization
Program
SubClass
Budget Yr.
Project/Grant
Shortcode
   


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