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Online Request Form

Requests must be placed by 4:00 PM one business day
before the equipment is needed.
See Request Deadlines for special holiday deadlines.


Contact Information
Last Name:      First Name:      
Department:     Phone Number:
E-mail Address:
Additional Contact Information (i.e. cell phone)

Equipment Information

For detailed equipment descriptions click here.

Item #1:

Item #2:

The asterisks (**) denote portable equipment,
which must be picked up in our office, Miriam Hall Room 53,
during our normal business hours.

Are you going off-campus with the portable equipment?  Yes No
If yes, please read our equipment loan policy.


Location Information

For portable equipment select the building Miriam Hall, and specify 053 as the Classroom #.

Building    Classroom  #

PC Carts and TV/VCR Combos are only available in Kettering Labs, Humanities Center, St. Joseph's Hall, and the Science Center.
Outside of these locations, we may have other types of equipment to suit your needs.  Use the "Special Requests" section of this form to make a special request for other locations.


Time Information

Specify the class start and finish times.
Equipment will be delivered prior to class start time.

Class Start Time: AM
PM
Class Finish Time: AM
PM

Date Information

Specify the Start Date

Start Date: Month
Day
Year

Is this a weekly request? YES NO
If YES, check the days of the week for which this request recurs
Monday Tuesday Wednesday Thursday Friday

Specify the Finish Date

Finish Date: Month
Day
Year

Would you like to repeat this request for additional date(s)?

If YES, enter each additional date on a separate line in MM/DD/YY format:

If the equipment type, times, or location are different you must submit a separate request.


Special Requests

Specify your requirements for non-standard requests or event support.
Service charges and rental fees may apply.


Requests are processed each business day in the order in which they are received.
An order confirmation e-mail or follow-up e-mail will be sent to the e-mail address specified in the Contact Information section of this form.

If you have any questions about this form, e-mail ClassroomSupport@notes.udayton.edu.
This form was last updated October 26, 2005.

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