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Contact Information
Kathleen Randall
Director of IITS Operations, Multimedia, and Computer User Support Services
(315) 792-3164
Please do not type anything in the following field
Media Center Request Form
*
indicates required field
The Media Center requires at least 24 hours notice. If 24 hours notice is not given the Media Center cannot guarantee that equipment will be available/delivered.
THIS IS A REQUEST ONLY. YOU WILL RECEIVE AN E-MAIL CONFIRMING THE EQUIPMENT AVAILABILITY.
Requestor
First Name
*
Last Name
*
Phone Number
*
E-mail Address
*
Equipment Needs
Room #
*
Start Date
*
End Date
*
Days of the Week
Sun
Mon
Tue
Wed
Thu
Fri
Sat
Start Time
*
AM
PM
End Time
*
AM
PM
Equipment Needs
*
Smart Cart
Qty
1
Smart Board
Qty
1
Projector (on-campus)
Qty
1
Wireless Laptop Lab
Qty
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
Projector (off-campus)
Qty
1
Laptop (off-campus)
Qty
1
VHS TV
Qty
1
DVD TV
Qty
1
Overhead Projector
Qty
1
Document Camera
Qty
1
Easel
Qty
1
2
3
4
5
6
7
PA w/Podium
Qty
1
2
3
4
Video
(List Title Below)
Qty
1
Other
(Describe Below)
Describe Needs
Attachment
Printable Version
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