Online Classroom Media Equipment Reservations


Please fill in the form below to request media equipment for classroom use only. 48 hour notice is required for classroom deliveries. Completion of this form does not guarantee delivery of the requested equipment. Equipment will only be delivered after you receive an e-mail confirmation from Academic Media Equipment Services. Borrower is responsible for all equipment from time of delivery until time of pickup.

Please fill out the fields below.

* Required fields

* Person making request

 

* Phone

 

* E-mail

 

*Date of request
(mandatory 48 hours before delivery date)

 

* Date of Delivery

 

Date of Pickup

 

 Same day
 Other:

Delivery Building

 

Delivery Room

 

Delivery Time

 

Pickup Room

 

Pickup Time

 

Equipment requested

 

 35mm Projector
 Boombox with CD & Cassette
 Camcorder
 Cart
 Cassette Recorder
 Data Projector
 DVD Player
 Easel
 Easel with pad
 Laptop Computer
 Laptop Computer with Internet
 Laptop Computer with External Powered Speaker
 Record Player
 TV
 VCR

Other equipment

 

Your Name: