Media Services Equipment Request Form

  
 

Please note:
All requests must be made with at least 7 business days advance notice. Requests sent Friday-Monday will not be processed until Tuesday of the following week. Media Services (MSO) will email 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 #:
Must be listed in BOCA. Equipment can be reserved for class meeting time.

 
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:
Please indicate actual event start and end times. Do not pad these times. MSO will allow for appropriate set-up and take-down time.

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 event
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 (PowerPoint, Video)
Slide Projector w/Carousel (35mm)
Wireless Remote (for 35mm slide projector)
Overhead Projector (Transparencies)
   
Video
Selected
VHS VCR
TV/VCR 19" combination unit
TV/VCR 13" combination unit
VHS Camcorder
VHS-C Camcorder
Mini-DV Camcorder (digital tape format)
Mini-DVD Camcorder (small DVD disc format)
Document Camera
Multi-standard VHS (NTSC, PAL, SEACAM playback)
Region-free DVD
DVD Player
VCR (VHS U.S. Standard)
Digital Still Camera
   
Audio
Selected
(please note portable audio equipment will not be delivered)
Portable Speakers (for use with video playback presentations to 25 people or less)
Marantz Flash Card
Digital Audio Recorder
Boombox with CD Player
Audio Recorder (Marantz)
Audio Recorder (Walkman-style micro cassette)
Audio Recorder (Walkman-style standard cassette)
Transcribing Machine (micro cassette)
Transcribing Machine (standard cassette)
   
Miscellaneous
Selected
Tripod (for use only with MSO camcorders)
Port-a-Stand (collapsible table)
Laser Pointer
Screen
   
Videotaping
(MSO staff service. Pricing estimate will be included in confirmation.)
Selected
VHS (documentation purposes)
Mini-DV (consumer digital)
DV Cam (professional digital)
   
Video Screening
Selected
Pembroke 210
SciLi 818
SciLi 1418
   
Audio in Salomon/Smith Buonanno 106
Selected
Microphone (wireless hand held)
Microphone (wireless lavalier)
Microphone (condenser, stereo)
Microphone (panel discussion table)
Microphone (podium)
Microphone (audience Q&A)

Base Audio fee of $65(Salomon 001, 101 & Smith-Buonanno 106)
Includes house audio system. Microphones and recording fee addiitonal.
   

Pricing Details

Comments:

All requests must be made with at least 7 business days advance notice. Requests sent Friday-Monday will not be processed until Tuesday of the following week. MSO will email confirmation regarding your request. Some details may change to reflect MSO policies and conform to security issues.

Please type your initials if you accept these terms.

Please check your information carefully before submitting this form.