Order Form | Reserve Classroom Equipment

Please submit equipment request at least 2 business days prior to the class.

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* denotes required field

Contact Information
Account InformationA department account number is only required for select items (laptop, projector, lavaliere mic., mp3 recorder, video camera). Account number will be charged if the equipment or supplied accessories are lost, broken or stolen. Department’s account number will also be charged for late returns at the discretion of Campus Media.
Course Information *
Location *
Loan Period

Semester Loan

A Semester Loan allows you to keep the equipment for the entire Semester. Select this option if you require an item the entire duration of the Semester.

Pick-up Return Daily

Equipment is picked up day of class and returned after class.

Date(s) and Time(s) *
(e.g. 6:20pm)
Classroom Equipment and Services

Audio

Video

Video Recording
Video Playback

Projection

Laptop Request

Other Services

Notes
This is my personal computer, please remember my information for next time.