Username: Email:
First Name: Last Name:
Department: Phone:
Purpose for checkout:
Checkout Date (click calendar icon & WAIT for popup ->): [None] Pickup Time: 0800 0830 0900 0930 1000 1030 1100 1130 1200 1230 1300 1330 1400 1430 1500 1530 1600
Return Date (click calendar icon ->): [None] Return Time: 0800 0830 0900 0930 1000 1030 1100 1130 1200 1230 1300 1330 1400 1430 1500 1530 1600
_______________________________________________________________________________________________________
Audio Other:
Camera or Video Other:
Other Projection Equipment:
Other Miscellaneous Equipment: