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Equipment Request Form
Educational Technology Resource Center | DoIT

Important note: many Roosevelt classrooms now contain built-in display and projection equipment. For information on using computers in these spaces see the classroom computer policy. To request space and equipment for non-instructional purposes use the non-classroom event form. See also the General Policies and Procedures page.

*required
Instructor Information
*First name
*Last name
*Daytime phone
*E-Mail
  
Equipment Requested
Note: All computers come with Microsoft Office (Word, Excel, PowerPoint, and Access) as well as a Zip drive.
Computer with projector Projector only TV/VCR
Overhead projector CD/cassette player DVD player
Digital camera Beta player  Video camera
Slide projector Flip chart* Markers* (Robin only)
Easel* (Robin only) Extension cord Video (use Comments area) 
 * Not available at the Gage building
 
Required: Please indicate what type of Internet access you require.
(click here for more information)
Internet access
Banner (includes Internet access)
None
 
Location
Campus
Room number
  
Course Information
Course name
Course number
 
Date and Time
(if you need this equipment on more than one date, enter the first date/times in the box below and enter the rest of the dates/times in the Comments section)

Month:  

Day:  

Year:  
Start time:    
Ending time:  
 
Comments
(if you need access to special systems, like BSR, include in your comments)

 
Audio Visual requests must be made at least one day in advance.  Video taping and/or aide request must be made one week in advance.

All equipment is delivered on a first come-first serve basis.

DoIT | Educational Technology Resource Center

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