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Equipment/Service Request form
You may use this form to request equipment or services from the Media Center. When you are finished filling out the form, a Media Center staff member will confirm your request. Please allow at least 24 hours to process your request.
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* Indicates required question
Name
*
Your answer
Email
*
Your answer
Date Needed
*
MM
/
DD
/
YYYY
Class Period
1st
2nd
3rd
4th
5th
6th
7th
All day
...At your convenience
...As soon as possible
...Before School
...After school
Room#
*
Your answer
Equipment/services requested.
*
Binding Machine & Combs
Bulletin Board Paper
Camera, Digital
Camera, Video
Cart
CD Player/Boombox
Computer, Laptop
Die-cut letters
Easel
Elmo Document Camera
Extension Cord
Headphones
Headphones w. Microphone
Laminate
Microphone - Handheld
Paper Cutter
Podium
Print Poster
Projector, LCD
Projector, LCD (Dual Unit)
Promethean Board (mobile)
Remote Navigator (usb wireless remote)
Screen, Portable, Small 40”
Screen, Portable, Large 70”
Speakers
Tape Player
Tape Recorder
Transfer & Upload Video to Google Video
Tripod
Other:
Required
Other helpful details? (For example, time/quantity needed, file being emailed separately, length of bulletin board paper needed, item needed for multiple days, other special consideration, etc.)
Your answer
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