Media Services Equipment Request Form

 
 

Please note:

All online requests must be made with at least 7 business days notice. Requests sent Friday-Monday will not be processed until Tuesday of the following week. If you have a last minute request please call the Main Office: 863-2197. Media Services (MSO) will send out confirmation regarding your request. Some details may change to reflect MSO policies and conform to security issues.

* Fields are required
Contact Information:
*Name:
*Phone: Fax:
*Email: Campus Box:
*Department/Organization:
Alternate Contact Name:
Alternate Contact Phone:
Alternate Contact Email:

Billing Information:

(* Select one of Tier 1 or Tier 2 or Tier 3)

Tier 1:
Course Related   Course #:

 
Tier 2:
Student Group
      Student Group Name: and Category:
      (Both are required if Student Group is selected)
Administrative Department
      Account Number: (Required if Administrative Department is checked)
 
Tier 3:
External User
      Please Describe:
Other User:
      Please Describe:
      Account Number: (Required if Other User is checked)

Event Information:
*Event Date:
*Event Start Time: *Event End Time:
MSO will determine confirmed set up and break down times.

~
Location:
*Building: *Room:

Delivery Method: (User must choose one)
User will Pickup and Return Equipment
Media Services will Deliver and Pickup Equipment

If You WILL be using Installed Equipment:

Do you need an Operator?
Yes, I will need an operator
No, I will not need an operator
 
If you will need an Operator, indicate for how long:
For the entire time
Only during setup/take down
 

Equipment Requested: (mark all that apply)
If you are unsure what equipment you need, call the main office at 863-2197.

Price Guide
Projectors
Selected
Data/Video Projector
Slide Projector w/Carousel
Wireless Remote (for slide projector)
Overhead Projector
   
Video
Selected
VCR & speakers (video presentation)
TV/VCR 19" combo
TV/VCR 13" combo
VHS Camcorder
Mini-DV Camcorder
Document Camera
Multi-standard VHS
Region-free DVD
DVD Player
VCR
Digital Still Camera
   
Audio
Selected
(please note portable audio equipment will not be delivered)
Portable Speakers
DAT Recorder (Tascam)
DAT Recorder (Sony TC-D8)
Boombox with CD Player
Audio Recorder (Marantz)
Audio Recorder (Walkman-style)
Transcribing Machine
   
Miscellaneous
Selected
Tripod
Portable Stand
Laser Pointer
Screen
   
ONLY AT SALOMON/SMITH-BUONANNO 106
Selected
Microphone (wireless)
Microphone (condenser, stereo)
Microphone (others)

Base Audio fee (Salomon 001, 101 & Smith-Buonanno 106)
Does not include microphones or recording

   

Pricing Details (Price Guide)

Tier 1 (No fees incurred) : ALL of the following conditions are met:

  • A course number must be provided.
  • The course must be for credit and within a course of study that is part of a University undergraduate or graduate degree program offered by a recognized University department.

Tier 2 (50% reduction off Tier 3 fee schedule) : The following conditions are met:

  • 50% or more of the attendees are members of the Brown Community. This includes full or part-time faculty; full or part-time staff, matriculating students and alumni.
  • The event in question must support the focus and purpose of the University.
  • There is no fee paid to register or attend the event. Media Services recognizes that student group events and most University department events can be defined as a Tier 2 event and we are happy to provide our services at a 50% reduction off the Tier 3 fee schedule.

Tier 3 (full price)

  • Less than 50% of the attendees are affiliated with the University.
  • The primary sponsoring organization is not affiliated with the University.
  • The event or conference is an annual event with a shifting venue from year-to-year.
  • There is a registration fee paid by attendees. Events that fall under Tier 3 pricing are those that, while using University facilities and perhaps being organized by University personnel, are primarily for ‘external' consumption or are benefiting the external groups.
Comments:

All online requests must be made with at least 7 business days notice. Requests sent Friday-Monday will not be processed until Tuesday of the following week. If you have a last minute request please call the Main Office: 863-2197. MSO will send out confirmation regarding your request. Some details may change to reflect MSO policies and conform to security issues.

Please type your initials if I accept these terms of agreement

Please check your information carefully before submitting this form.