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Equipment Request Form

Requests for audio-visual equipment are accepted from faculty and staff.

Contact Tony Gravette or Michael Walker for more information.

NOTE: Equipment requests require 24 hours advanced notice.

Required fields are indicated with an asterisk (*).


(*) Name:

(*) Email Address:


(*) JSU Status: Faculty Staff NON JSU

(*) Campus Phone:


(*)Will this be a: Pickup or  Delivery?

(*)Date Event Begins:/

(*)Beginning Time::

(*)Date Event Ends:/

(*)Ending Time::

For multiple day events, please specify dates and times:

(*)Where will event be held?                     (*)Room #

(*) Description of event
(Example: Power Point presentation, John Smith's Lecture)

(*)Equipment Needed (select all that apply)
Laptop Computer with DVD Drive
         (Related Equipment)
        W/Floppy Drive    W/Internet    W/Sound

VGA Projector (Computer Projector) 

Projection Screen on tripod
Projection Table

       (Type)   On podium   On stand   On table
                  Wireless lapel     Wireless handheld
                  Mic only

P.A. Podium (All in one unit 1 microphone is included)
P.A. System with Speakers
Compact Disc (CD) Player W/FM AM Radio (Boom Box)
Conference Phone
      (for Web conferences or Telephone conferences)

      Video Camera:
         (Type)  VHS tape  OR   MiniDv tape
           (Related Equipment)
       On tripod   On wheel-it   With TV monitor

TV Television with Television cart
DVD Player
Slide Projector
Overhead Projector

Visual Presenter (Elmo)
Iron Easel
Other Equipment

  (General Notes)
  If more than one piece of equipment is required or not
  listed above, please specify below.
(Example 2 TVs)

NOTICE: By default, the person requesting equipment is responsible for securing all equipment until picked up by Audio Visual Services. If equipment will be secured by anyone other than requesting person, please specify name and contact number

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