Equipment Reservation

To avoid scheduling conflicts, please provide the information requested on this form two weeks prior to your equipment request date. This information will be sent to Stanley Smoniewski, Technology Coordinator, located in Winther Hall 1006B.
Requests for reserved use of equipment will be confirmed as soon as possible. Reservations are scheduled on a first come-first serve basis.

Faculty Member Name: Error: You must enter the name of the faculty member.
Email Address: Error: You must enter an email address. Error: Please enter a valid email address.
Phone Number: « Format: digits only Error: You must enter a phone number. Error: The phone number must only contain digits.
Pickup Date: « Format: mm-dd-yy Error: You must enter a pickup date. Error: Please enter a pickup date in the format mm-dd-yy.	Time:
Drop Off Date: « Format: mm-dd-yy Error: You must enter a dropoff date. Error: Please enter a dropoff date in the format mm-dd-yy.	Time:
Equipment Requested:
Portable Computing PC Laptop Mac Laptop iPad iPad Classroom Kits More Information (reserved in multiples of 5 only) 5 10 15 20	Digital Still Camera Compact Telephoto
Digital Video Camera FlipCam Mini DV Video Camera	Other Voice Recorder LCD Projector
Please provide a brief description of your needs. (i.e. What software/cables you may need.)
Please verify you are a human by answering this question: What is 1 + 1?ERROR: Please verify you are not a spam-bot by completing all fields.

Equipment Requested: