AUDIO/VISUAL REQUEST FORM

Name of Sponsoring Group:__________________________________________________

Contact Persons (3):________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

Event Name:_______________________________________________________________

Date of Event:______________________________________________________________

Location of Event:___________________________________________________________

Time of Event:______________________________________________________________

Please note that your group will be charged for a staff member from the
Audio/Visual Department to attend your event and maintain the equipment requested.
Event leaders should contact Audio/Visual at 212 353-4264.

Audio/Visual Needs (Check all that apply):

[ ] use of viewing screen; time needed:___________________________________________
[ ] use of DVD player; time needed:______________________________________________
[ ] use of TV monitor; time needed:______________________________________________
[ ] use of microphones; number needed:__________________________________________
                                      time needed:_____________________________________________

[ ] other needs (Please specify equipment and time needed):

___________________________________________________________________________

___________________________________________________________________________

RETURN THIS FORM TO STUDENT SERVICES AT LEAST TWO WEEKS PRIOR TO EVENT