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Webb Media Equipment Request Form

Last Name*

First Name*

Midas ID*

ODU email address

Campus Extension

Other Phone number

Department/Organization *

Event Date*

Location of event*

Time Equipment is needed*

Time equipment can be picked up*

Resource Information

University policy (3400-1) restricts equipment use to official business purpose only. Borrower is responsible for equipment damage, theft, copyright violation. This equipment is for Norfolk campus use only.

Check the equipment needed for your event. (We do not supply notebook computers)

Data Projector

Data projector w/sound

TV/VCR Combo

Projection Screen

DVD/VCR player

Transparency Projection (overhead)

Wireless Microphone

Wired Microphone

CD Player

Equipment Cart

Speaker Phone

Additional Information:

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