Instructional Technology Services

Order for Event Media Services /
Equipment Request Form

Name: *

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

Phone *

Department

Address 1:

Address 2:

City:

State:

Zip:

Start Date (mm/dd/yy)

All orders should have at
least 2 business days notice.

End Date (mm/dd/yy)

Start Time (hh:mm AM/PM)

End Time (hh:mm AM/PM)

Location

Days of the week Required.

Monday
Tuesday
Wednesday
Thursday
Friday

Is this is a regularly scheduled Catalogue Course

If Yes. pls. List your Course Number

If No. pls. List your Account Number

What equipment will you need?

Other equipment needs :

Comments :