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

Delivery Building


Delivery Room


Delivery Time


Pickup Room


Pickup Time


Equipment requested


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

Other equipment


Your Name:


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