Audio/Visual request

The form below will allow you to quickly and easily submit your Audio/Video needs. Please fill in the form with as much detail as possible, and click the submit button when finished.

Contact Email
Group Name
Contact Name
Date of Visit
Phone Number

Will you need internet connections?	Yes No
If so, how will you be connecting?
If using ethernet, what is your MAC (network adapter) address?
Will you be connecting to a website?	Yes No
What Operating System will you be using?
Do you need to connect to any WMU systems?	Yes No
If yes, please specify:
Do you have any special connection requirements?	Yes No
If yes, please specify:
Do you have any special configuration requirements?	Yes No
If yes, please specify:
Do you need to connect to any outside systems?	Yes No
If yes, please specify:

Select any needed equipment from the following lists. ( Hold down the control button to select multiple items.)
	Projection Equipment
	35mm Slide w/Wireless Remote and Screen ($25) Overhead Projector w/Screen ($20) Screen Only ($20)
	Video Equipment
	1/2" or 3/4" Video Cassette Recorder ($55) 25" Monitor ($25) DVD Player ($25) Blank 1/2" Tape ($15) Video Projector w/Screen ($75) Tripod (no charge)
	Audio Equipment
	Portable Cassette Recorder ($15) Blank Cassette Tapes ($5 each) Podium Microphone (no charge) Conference (PZM) Microphone Lavaliere-Wireless (no charge) Handheld-Wireless (no charge) Portable PA ($20) CD Player ($15)
	Other Equipment
	Upright Piano ($25) Grand Piano ($45) Dance Floor (24' x 30') ($100) Laser Pointer ($15) Flip Cart w/Pad and Markers ($20) 3M Flip Chart w/Pad and Markers ($25) Whiteboard and Markers (no charge) Easel (no charge) Telephone Hook-up ($10) Extension Cord ($5) Power Strip ($5) Speaker Phone ($20) Polaroid Camera w/Ten Exposures ($30/day) Laptop Computer ($100) A/V Cart ($10 Copies (10c Each) Faxes (no charge) A/V Assistance ($20/hour) Computer Technician (Price TBD after consultation)

Additional needs and information: