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Equipment Requests

The responsible party for all equipment must be a faculty or staff member.
Faculty/Staff Name
Email address	extension:
Name of person picking up (if different)
Equipment may be picked up in and returned to Room 539 unless otherwise noted
For Use in Room #	OR	Offsite Building
Date Pickup		Date Return
Time Pickup	8:30-9:30 am 12:00-12:30 pm 4:00-4:30 pm	Time Return	8:30-9:30 am 12:00-12:30 pm 4:00-4:30 pm
Equipment needed	Laptop (comes in a bag) Computers are permanently installed in rooms 112, 113, 168, 170, 253, 261, 369 and in the Special Events Forum. features: CD DVD Wireless Other New Wireless Buzzer System (6 player) with Light Tower* Clickers (comes with receiver, software on USB) Quantity: 1-50 50-100 Remote for PowerPoint Portable LCD Projector VCR or DVD player to use with (choose one) Projector TV Digital Camera Video Camera Portable Amplifier (for walking tours) Webcam (Logitech 9000 with mic) Other Describe:
Additional Comments
	By submitting this request I hereby agree that I am responsible for the equipment listed above and that if such equipment is not returned in the same state, that I will be held responsible for the replacement, repair, or monetary reimbursement for such equipment.