Required Information:
 

Contact Name:			Phone Number:
Event Name:			Location:
Department:			Date(s):
Start Time:			End Time:
Organization # (5 characters):			Fund #:
Email:
	*Fields in red are required.

Optional Information:
 

Account #:		Project #:
Program #:		User Defined:

Equipment Requested:
 

Audience Response System	Audio Conference Phone	Audio Mixer	Audio Tape Recorder
CD Player	Computer PC	Computer MAC	Corded Reel
Digital Overhead	Camera Digital Still	Camera Digital Video	DVD Player
DVD/VCR Combo	Internet Access	Laser Pointer	Projector LCD
Operator Time	Mic Podium	Portable Screen	Portable Sound System
Presentation Remote	Mic Table Stand	VCR-VHS	Wired Mouse
Mic Wireless Handheld	Mic Wireless Lav	Camera VHS	Projector Overhead
Projector Slide	TV-VCR Unit

Additional Notes or Requests:

*All requests tentative until confirmed by Presentation Services

Presentation Services may be contacted by calling 2-8099 or fax 8-8479 from 7:00 A.M. - 6:00 P.M. Monday through Friday.