Audiovisual Setup Request Form

Do you have a class or an event that will require an audiovisual setup? If so, you can use this form to help you make sure that you have thought of all of your A/V needs ahead of time. Just fill out the form below and submit it when you're done. You will recieve a copy of the data sent so that you may verify your request. The A/V office will then contact you if they need to finalize any details.

Fields with a dark red star (*) must be filled in before the form can be submitted.
Please do not use the " character in any of the one-line text boxes as this may cause the information you entered to be lost.

Name*:
Email*:
Name of class/event*:
Room/Area where class or event will take place*:
Beginning date of class/event (mm/dd/yyyy)*: / /
Start time (hh:mm)*: : AM PM
Ending date of class/event (mm/dd/yyyy)*: / /
End time (hh:mm)*: : AM PM

If this will be a weekly setup, please specify the day(s) and time(s) needed:

What audiovisual equipment will you require? Please be as specific as possible.

Computer Equipment:

Mac on a cart PC on a cart
If you will be using a computer, will you need access to the CIS file server Charlie or another file server?
Yes No

If you will be using a computer, will you need access to the Internet? (For example, will you be using an application requiring a TCP/IP connection?)
Yes No

Projection equipment:

Slide projector Video projector Other
If you selected Other, please specify:

Video equipment:

Laser disc player VCR and TV TV Video camera Other
If you selected Other, please specify:

Audio:

Microphone Wireless microphone Other
If you selected Other, please specify:

Please select one of these setup options:
I need AV to deliver and setup the equipment in the indicated room.
I need AV to deliver, setup, and oversee running the equipment in the designated room.

Would you like to meet with Michael sometime before your class or event for him to demonstrate the use of the equipment?
Yes No

Additional instructions or other equipment needed?

Please check your mail for verification of what was sent and let us know if any changes need to be made asap.

HMC / Computing and Information Services/ webmaster@hmc.edu

Revised: July 18, 2003 by Kamil A. Wnuk
URL http://www.hmc.edu/comp/services/forms/avrequest.php