These items need to be signed out of HC 115 by the requestor or contact. The requestor or contact is solely responsible for this equipment.

Requestor:
Phone:
Email:
Type:		FacultyStaffStudent
Department:
Contact (if diff. from requestor):
LCD Projector (to be used with computer):
Projection Screen - SM:
Projection Screen - Md.:
Projection Screen - Lg:
Document Camera:
Presentation Remote:
TV / VCR / DVD:
Video Camera:
Tripod:
Slide Projector:
Public Address System:
CD Player:
Cassette:
Overhead Projector (to be used with transparencies):
Please choose a date and time for your request. ***Please note, we are closed Saturdays and Sundays.
Monday:
Tuesday:
Wednesday:
Thursday:
Friday:
Dates Requested:
Days and times entered for the durration of the simester.:
Room/Location:
Class/Event Start Time:
Class/Event End Time:
Notes:

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