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AV Services Request

for Faculty & Staff Only

If you’re unsure of what you need or how to use the equipment, please call Media Services at ext. 5314 for assistance.

If you’re knowledgeable of presentation equipment please complete and submit the form below.

Please Note: A 24 hour advance notice is requested for AV services. All requests with less than a 24 hour notice will be handled on an "as available" basis.

First Name:
     

Last Name:
     

Status (used for statistical purposes only):
      Full time faculty/ staff
      Associate faculty, part-time staff
      Officials: (ie. retiree, Institute for Senior Professionals, Board of Trustees, Americorps, Foundation Board Member, Consortium (FCCSC) )

Daytime Phone Number:
     

Email Address:
     

Name of Event:
     

Start Date:

Start Time:

End Date:

End Time:

Room Number / Location:
     

Expected Audience:
      1 - 10
      11 - 25
      26 - 50
      Over 50

I wish to:
      pick up the equipment
      have the equipment set up

Equipment Needed:
      Lectern with sound system
      VCR/DVD & TV
      Video (LCD) Projector
      Projection Screen
      Other: characters left

Please review your selections before submitting this form. Thank You.