IPFW: AV Technology Services: Equipment Request Form

AV Technology Services

Note: All technology requests should be submitted at least two (2) business days in advance to ensure best service.

Your Name:
Your Department:
Your Email:
Name of Course / Event: (If a Course, include course #)
Instructor:
Date(s) of Your Event:
Date Equipment Needed:
Date Finished with Equipment:
Your Phone Number:
Room where equipment is needed:
Bldg where equipment is needed:
Time Event Starts:
Time Event Ends:
Time Equipment needs set up by:
Earliest Time we can access the room to set up:
Time we can take down the equipment:
Equipment Needed (be specific):
AVTS technician needed:	Yes No
Note: if a technician is required during non-working hours, labor fees will be incurred by you or your department.
If you are providing the computer that will tie in to our equipment, we need to know your computer:	Brand: Model: Operating System:
If you are providing the CD/Software/Media (Power Point, Photoshop, etc.) that will be used in our computer, we will need:
Name of the software you are using:
Version of the software you are using (2003, 2007, etc.):
Note: This form must be completed in its entirety in order for your request to be scheduled. All requests must be received by the AVTS office at least 2 business days prior to your event date. If you have questions, please contact John Fitzgerald at 260-481-6519 or fitzgera@ipfw.edu