Classroom Delivery

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: