1001 A/V Request

1001 A/V Request

Requestor*
First Last
Area/Committee*
PURPOSE*
POC Phone Number*
POC Email*
Enter Email Confirm Email
Locations*
Start Date*
MM slash DD slash YYYY
End Date*
MM slash DD slash YYYY
Event Time Start*

: Hours

Minutes

AM/PM
Event End Time*

: Hours

Minutes

AM/PM
Equipment needed
Check all that apply.
- Screen
- Podium Microphone
- Wireless Microphone
- Standing Microphone
- Camera/Recorder
List required support*
Any cost incurred will be the responsibility of the requestor. ALL REQUESTS ARE SUBJECT TO AVAILABILITY OF FUNDS. EANGUS IS NOT RESPONSIBLE FOR LOST OR BROKEN EQUIPMENT. THIS FORM IS TO BE FILLED OUT BY THE REQUESTOR AND/OR WHO WILL BE RESPONSIBLE FOR EQUIPMENT. CONFERENCE ATTENDEES/REQUESTORS ARE NOT AUTHORIZED TO DIRECTLY COORDINATE WITH THE CONVENTION CENTER AND/OR EANGUS CONTRACTED CONFERENCE FACILITIES. ALL REQUESTS MUST BE SUBMITTED AND APPROVED BY THE CONFERENCE CHAIRMAN.