Technology Equipment Request Form

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Important Note: Do not use this on-line form if you are requesting for tomorrow or the next day. To make same-day or a next-day requests, call CETS at 202-687-7491 or come to the CETS service desk, ICC 121. Use this form only if you are requesting equipment and service two or more business days in advance. Also note that on-line requests submitted after 5:00 p.m. Friday will not be responded to until mid-day Monday due to a large volume of business. Please do not use this form to reserve a classroom. All room reservations MUST be done through the University registrar's office.
Requester Information
First Name				Last Name
Email Address				Daytime Phone #

Event Information
Professor/Lecturer
Course Number #
Building	Select Building Car Barn Healy ICC Lauinger Maguier New North New South Reiss St. Mary's Reynolds Walsh White Gravenor		Room Number
One Time/Recurring Request	Select Request Type One Time Request Recurring Request
Day(s) of the Week	Sun Mon Tue Wed Thu Fri Sat
Start Time			End Time
Start Date			End Date

A-V Equipment
Audio	CD				Cassette				Lecternette
	MP3
Video	DVD				Computer Proj.				16mm Proj.
	VHS				Transparency Proj				Slide Proj.

Media Titles
Title Name
Title Number

Computer Equipment			Software List
Request CETS Computer/Bringing Personal Laptop	Select Option CETS Computer Personal Laptop

File Access
Floppy	USB	CD	DVD	Internet

Comments/Notes (Use this field to clarify elements of your request.)