Curry College - Media Services Request Form

Media Services Request Form

Fields marked with * are required

Contact Information

Name *
E-mail *
Department
Telephone

Event Information

Building
Room Number
Is this a reccurring request?	Yes No
Date of Event
Time of Event:	to
Recurring Request End Date
Special Arrangements
Special arrangements may be made for equipment and services needed at times other than regular office hours.

Select Equipment Needs:

Audio/Visual
	Projector Screen		Digital Video Camera
	Camcorder (VHS)		LCD (Data Projector for PC or Laptop)
	CD/Cassette Player (Boom Box)		VCR Player
	DVD Player		Smart Board
	White Board (Dry Erase Board)		Slide Projector
	Overhead Projector (Transparencies)		Sound System
	Television

Computer/internet	PC Laptop Internet
Special Software Needed

For all other Media-Related services, please contact Media Services at 617-333-2142.