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Media Services Work Order

Use this form to submit a media services work order or, if you prefer, CLICK HERE to download a printable version in PDF format.

* = required field

*Person requesting:
*Phone number:
(000) 000-0000
*Date and time needed:
(Please allow set-up time)
*Building and room number:
*EQUIPMENT: (Check equipment needed or specify other needs in the fields below.)
TV/VCR
PA Equipment
Wireless Microphone
Standard Microphone
Multimedia projector
Overhead Projector
Laptop
Audio Cassette Recorder
CD Player
Dubbing
Screen
Slide projector
Cassette Player
Studio camera
Video Conferencing (depending upon room availability)

Other equipment needed or special instructions of needs or supplies:

Equipment needing to be repaired and room number:

We need 24 hours notice for equipment (set-ups and so forth) so that the equipment will be in the correct place waiting for you. For requests occuring on weekends (Friday evening-Sunday), please provide at least 48 hours notice. Your I.D. will be used to check out all equipment. Please have your valid I.D. with you when you come to the library. You may be held responsible for any damages to the equipment while it is in your possession. If you must cancel class, end class early, or otherwise leave the equipment unattended, please contact Media Services so that we can pick up the equipment. To ensure that your audio/visual needs are handled promptly and accurately, we ask that you submit this form rather than call in your request. You may also use the printable form, AVAILABLE HERE. All requests will be confirmed by Wilbert Lively, Media Specialist.