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Event Set Up Request Form

Page One

Please use this form to request Academic Affairs ITC support for a meeting or event. This form should be submitted at least 3 business days prior to your event.

1. Your Contact Information:

First Name *This question is required.

Last Name *This question is required.

Department *This question is required. If your department is not listed, please contact your department to ensure you are requesting the correct ITC support.

Email Address *This question is required. This question requires a valid email address.

Phone Number *This question is required.

Mobile Phone

2. Event Contact Person InformationIf the contact person who will be on-site is different than you, please complete the following:

First Name

Last Name

Department

Email Address This question requires a valid email address.

Phone Number

Mobile Phone

3. Event Information *This question is required.

Name of event
Date of event
Building Location(s): include building(s) and room(s)
Event start time
Event end time

4. Is the event recurring? *This question is required.

5. Please list additional dates, or details regarding the recurring event. *This question is required.

5. Quantity of Equipment NeededLeave option blank if not needed

	Windows Laptop
	Mouse
	Keyboard
	Projector

	Clicker / Pointer
	Internet Access
	Conference Phone
	Audio Speakers

	Monitor
	Document Camera
	Web Camera

6. Specialty Applications/Equipment Needed

Skype
Movie Presentation
Other Please enter an 'other' value for this selection.

7. Please check the services you require for this event: (check all that apply)

ITC setup needed
ITC support during entire event
ITC take down needed
Equipment checkout only
Other - Write In (Required) Please enter an 'other' value for this selection. * This question is required.

8. Additional comments or notes for the ITC?

9. Feel free to upload any schedules, agendas or documents that will assist us with the event setup.

File: {{filename}} delete

Please Request the area to be accessible for set up at least 30 minutes prior to the presentation. Changes or cancellations should be reported as soon as possible.

NOTE: If you are using your own device to connect to the projector, please bring a VGA adaptor. If you are using an Apple device (e.g., MacBook or iPad), please bring the appropriate Mac to VGA adaptor.