Media Services

Media Services Equipment Request Form

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Please note: If your request needs to be fulfilled in less than 12 hours, please call us!

To request various media equipment from media services, please use the following form. If you have any questions, please contact us.

Please complete this form and press submit. All fields are required.

First Name:

Last Name:

E-mail:

Telephone: Area Code:–First 3 digits:–Last 4 digits:

Department:

Purpose. Paint us a picture of your goals, objectives, etc. Check all that apply:

Equipment Required. Check all that apply:

Equipment Will Be: Picked Up By Requester
Delivered by Media Services

Additional Requirements:

Educational Site: If Dandini Campus, specify building:

Room Number:

Date Needed: (mm/dd/yyyy) Time Needed: Hour :Minute: Morning/Afternoon:

Expected Date of Returned: Expected Time of Return: Hour :Minute:Morning/Afternoon:

By pressing submit, borrower assumes full responsibility for the equipment and agrees to reimburse TMCC for the loss or damage thereto. Sanctions maybe involved for failure to make restitution for loss or damage under this agreement.

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