Request for Audiovisual Equipment

You and Your Request 
Your Affiliation is with:
 MCG  or  MCG Health Inc.
This Request is:
An Initial Request Change to an Existing Request
Contact Name:
Department:
Phone Number:
E-mail:
Course # / Program Name:
Enter the course number or program name that this equipment is being requested for.
When and Where
Programs that begin before 8:00 a.m. or end after 5:00 p.m. may incur additional charges and require a Chart Field Combination number to be provided below.
Start Date:
(mm/dd/yyyy)
End Date
(mm/dd/yyyy)
Start Time:

 : 

AM PM

End Time

 : 

AM PM

Days Required:  
 Mon Tue Wed Thur Fri Sat Sun
Confirmed Building & Room Number:
 [ Required ]
Equipment Requested
LCD Multimedia Projector
Classroom Performance System***
Television
Computer
VHS Player (Standard 1/2)
Wireless Microphone
Internet Access*
Document Camera
Phone Conference Device**
Portable Audio System
Laser Pointer
Cassette Player
DVD Player
Audio Recording
Wireless Mouse
Podium
Microphone
Easel
Projection Screen
 
Additional Equipment Information 
Internet Access Point Wall Plate Number:
*Provide an Internet Access Point Wall Plate Number here if 'Internet Access' is checked in the 'Equipment Requested' section above.
Telephone Access Point Wall Plate Number:
**Provide a Telephone Access Point Wall Plate Number if 'Phone Conference Device' is checked in the 'Equipment Requested.
Classroom Performance System (CPS) Number of Students in Class:
***The number of students must be specified if a 'Classroom Performance System' is selected in the 'Equipment Requested' section above.
Billing Information [if needed] 
Campus Department, Chart Field Combination Number (CFC):
Programs specified above as occuring before 7:45 AM or ending after 4:30 PM may incur additional charges and require that a Chart Field Combination number be provided here. A Chart Field Combination Number is a PeopleSoft related number.
MCGHI Department, Billing Information to include Account Number:
Other Requirements or Comments 

 

Please Note: All requests must come through the submission process (not through e-mail). If you receive a submission error instead of the submission confirmation page, please try to re-submit. If you continue to encounter problems contact the IT Service Desk at 1-4000.

 

Revised September 24, 2009.   Please send comments, suggestions or questions about this page to IT Service Desk, ITService@mcg.edu .