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Information Technology Services
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Equipment and Media Order Form

On-Campus Use Only

Use this form when ordering media resources for delivery to your classroom. The appropriate equipment will be scheduled.

Online requests require a minimum of 24 working hours to be processed, Monday thru Friday, excluding holidays and weekends. All orders are delivered as setups unless otherwise specified in the special instructions area.

Name: Dept: Date: / / (Please enter month/day/year, 01/01/2003 for example.)
Phone: Box #: E-mail:
Media #
Title
Date Needed
Delivery &
Pickup Time
Building &
Room Number
/ /
Room:
/ /
Room:
/ /
Room:
/ /
Room:
/ /
Room:
/ /
Room:
/ /
Room:
/ /
Room:
/ /
Room:
/ /
Room:
Special Instructions: