Media Equipment: Checkout and Pickup

Equipment Request for Patron Pick-up

Advance notice is required for LCD projectors and laptop computers.
1-day loan for camcorders and 2-day checkout for other equipment.

******** Please Read Carefully ********

By filling out the form below, I (the requester) understand the equipment is for use by college functions only. I agree to take responsiblity for the condition and return of all equipment that will be checked out per this request; in the event that the equipment is missing or damaged, I agree to pay for the replacement or repair costs. In addtion, I agree to pay a $2 ~ $5 per day fee for every piece of equipment not returned by 5:00 pm on the due date.

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When is the equipment needed?
Date time ...

When will you pick up the equipment?
Date: Time:

Location of equipment usage:
Building: Choose one... OFF CAMPUS Blackwell Auditorium Brock Center Brown Campus Center Copley Science Center Estes Hall-Hughes Room Estes Hall-Trustees Room Fox Hall Haley Hall McGraw-Page Library Old Chapel Pace-Armistead Hall Peele Hall Thomas Branch Hall Washington-Frank. Hall Other (please specify) Room:

Please describe the R-MC FUNCTION.the equipment will be used for. (Example: DVD viewing by the Campus Activity Board). Note we do NOT check out equipment for non-college events.

Please list all the equipment you are requesting:

Any other factors that may help to serve you better? (such as network needs, dvd drive, wireless mouse etc).

Will you need instruction on equipment use?
YES...... NO