REQUEST FORM for Siena Heights University AV Department 

Please Note:  If you need to reserve a room as well as AV equipment, please click here to submit a complete request:


  First Name                           Last Name                                        Phone  

 

                                                                                  Email

     

  Instructor  Pickup      (In Computer Lab)                                           Delivery Requested  (if items are eligible)      

 

  Instructor  Return      (In Computer Lab)                                           Pickup   Requested   (if items are eligible)    

                 

 

  Date Needed                        (Please use  00/00/00  format)                    Date Finished     (Please use 00/00/00  format)

 

  Time Needed                                                                                 Time Finished                     

 

 

 

  Delivery Location   (if available)                               

 

  Pickup Location  (if different than delivery)                   

 

 

 EQUIPMENT NEEDED

  Items that are in  red  cannot be delivered and are normally limited to only one day's use at a time

 They are to be picked up and returned to the Help Desk on the third floor of Dominican Hall.

 

 


Projectors Audio Video  Computer Items
   16mm Projector     Record Player     VHS with Monitor         Notebook Computer
   Slide Projector

         Empty Carousel

         Zoom lens

    PA System

       Full standing unit   ( 2 pieces)

       Tabletop only

       Wireless microphone option   

             Handheld       Lavaliere

    DVD with Monitor           Data Projector
 

   1/2 VHS Camcorder

      Tripod

 

 

   Auditorium Powerpoint Setup

      

   Overhead Projector

 

    CD/Tape Boombox      (play only)
   Opaque Projector

      

                                                                                        

Other

      Screen
      Cart
      Extension Cord
      Easel       Paper pad
      Other  (please enter needs in box below)    

    

     Please enter other needs, directions or comments in the space below

 



PLEASE SUBMIT YOUR REQUEST

 

 

        After submitting your request, exit by closing the final acknowledgement screen.

 

        You will normally receive a response or confirmation within four hours during normal business hours.

 

 

 

                                                                                                                                                               


AV Request Form  08/18/2003 - Siena Heights University