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

Other equipment needs :

Comments :