Date Needed :

-- Provide Month, Day and Year (ex: September 13, 2008)

Provide Building and Room Number:

Enter Time Needed :

Enter time finished:

Name of Person Using the Equipment

Enter your name

Person Making Reservation (if different):

Enter the name

Contact Information (for person using equipment):

Department
Daytime Phone
E-mail

Choose A Status:

Faculty Student Staff Other

Select Computer Equipment Needed:

          Computer Projector (you must supply your own computer)
          Computer Cart for Hayward Hall
          Computer Cart for Downs Hall (Rooms 1-7 and 12 ONLY)
          Computer Cart for Downs Hall Auditorium

Select Video Equipment Needed:

VCR/TV (VHS-1/2 inch only)
Laserdisc Player/TV
DVD Player/TV

Audio-Visual Equipment Needed

Easel/Flipchart
16MM Projector
Overhead Projector
Portable Projection Screen
35MM Slide Projector (need only one)
35MM Slide Projector (need two)
35MM Slide Projector (need remote)

Audio Equipment Needed

Downs Auditorium Sound System
Ravenhill Dining Hall Sound System
Althouse Gym Sound System
Common Thread Sound System
Microphone(s)
Stand
Portable Sound System
CD Stereo Unit (in-class use only)
Other (provide description in box below)

Describe Equipment Needed If Not Found Above

Media Titles Needed, Special Instructions or Comments on Request