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Technology/Media Request Form


Your Information
* First Name You must be a current CEPS instructor, administrator,  or staff member to use this  form.
* Last Name
* Email * Ext.
Office Dept.
* Required
 
When, Where, and for How Long?
Class Period
on
or
Start
: on
  End
: on

Location
(Room #)



Repeat
Options
No Repeat Repeat
  Repeat Every:
Sun Mon Tues Wed Thurs Fri Sat
  Until:

What items are you requesting?  (Be specific!)
List of Available Equipment
Item 1
Item 2
Item 3
Item 4
Item 5

If the item you need is not listed, please describe the item(s) below

Comments:
Do not use quotes (") in the comments box

Please Note: ITC strongly recommends the reservation of all technology and media resources at least 24-hours in advance of the day and time needed.

 



Copyright 2005, ITC, College Of Education and Professional Studies at The University Of Central Oklahoma.   Email: ITC - SRC - FDC Webmaster / Rod Edwards / Disclaimer
Page updated 08/25/2005