Instructional Technology Services

One Time Event Media Services /
Equipment Request Form

Name: *

E-mail *
(must be @buffalo.edu)

Phone *

Department

Address 1:

Address 2:

City:

State:

Zip:

Date of Request

11/22/2009

Date Required * (mm/dd/yy)

All orders should have at least 2 business days notice.

Start Time (hh:mm AM/PM)

End Time (hh:mm AM/PM)

Location

Is this is a regularly scheduled Catalog Course

If Yes. pls. List your Course Number

If No. pls. List your Account Number

What equipment will you need?
(Wireless Microphones are now located in the teaching station for all rooms equipped with a PA system)

Other equipment needs :

Comments :