Technology & Media Production Department 26 Gibbs Street, Box 154 Rochester, NY 14604 Phone: (585) 274-1130 / Fax: (585) 274-1001 Email: [email protected] Presentation / Lecture / Meeting AV Equipment Request Form

Select Option Self-Serve Delivery & Pick-up by T&MP Staff

Please select the equipment necessary for your event.

Multiple Choices Allowed Wireless Internet Audio Speakers Audio Recorder (Compact Flash) with microphone & stand Laptop - PC CD Boombox Audio Recorder (CD) with microphone & stand Laptop - Mac CD Player Audio Recorder (Mini-Disc) with microphone & stand Projection Screen Laser Disc Player Video Camcorder (Hard Drive) with tripod Projector - Data DVD Player - Region 1 (North America) Video Camcorder (Mini-DVD) with tripod Projector - Overhead (transparencies) DVD Player - Regions 2, 3, 4, 5, 6 Video Camcorder (Mini-DV) with tripod Projector - Slide (35mm) VHS Player - (NTSC tapes only) (NO PAL) Digital Camera (Memory Card) with tripod Document Camera (ex. music scores) Media Cart (TV/DVD/VHS) Conference Call Unit

Are you giving the presentation? **Speaking Microphone required? ** Note: T&MP Dept. will determine: Yes No 1. if location has equipment capabilities No Yes, hand-held microphone 2. if event requires sound reinforcement If no, please list name, phone number, Yes, microphone with stand 3. if staff available to provide the service and email address for the presenter(s) in the additional information box. Audio or Video Conference Call required? If yes, please give further details

No Yes

Please answer the following questions to help identify equipment necessary for your event.

Laptop computer required? Presentation includes? PowerPoint Presentation? (multiple choices allowed) No Yes, a PC Display Overhead Transparencies Yes Yes, a Mac Display paper documents (ex. music score) Storage device for Presentation? No, will provide own PC Display 35mm Slides Personal Laptop No, will provide own Mac Play VHS tape (NTSC) (no PAL) External Hard Drive Thumb Drive Do you need a Mac adapter? Play DVD - Region 1 (North America) DVD Yes If Yes, which Mac? Play DVD - Regions 2, 3, 4, 5, 6 CD No Play Laser Disc University Network Drive Play CD Audio clips - iPod, MP3 player, laptop Video & Audio clips - Website (ex: Utube)

Wireless Internet required? No UR Wireless is the wireless network used throughout the Eastman School of Music and the University of Rochester. Yes Eastman provides UR Wireless in select areas of the Eastman campus for use by Eastman/University of Rochester students, faculty, staff and guests. See website for additional information. http://www.esm.rochester.edu/esmtmp/ecs/wifi.php

Do you require training and/or support from the AV Technician? If so please give further details.

Please continue to Page 2 Event Information

Event Date Start Time End Time Event Location

Event Name

Additional time prior to the start of your event reserved for set-up? Additional time after your event ends reserved for tear down?

No Yes Example: No Yes Example: Set-Up Time (12:30 pm - 1:00 pm) Tear Down Time (3:00 pm - 3:30 pm)

Customer Information University Affiliation U of R Campus First Name Last Name Phone Number Eastman Administrator Medical Center Faculty Memorial Art Gallery River Campus Staff Email Address Other Student None

Additional Information

T&MP Department lends equipment on a first-come, first-serve basis. It is best to reserve equipment at least one month in advance. There are no guarantees for equipment requested less than a week in advance.

Please complete this form and print/save as a pdf document. Email [email protected] and include the pdf document as an attachment.