WSUTC Media Equipment Request Form

Name of Requestor*

Affiliation with the University*

Staff	Professor
Student	Non-University

Instructor / Presentor*

Department / Organization*

Phone*

Email to send confirmation*

Class/Event*

Event Start Time*

AM PM

Event End Time*

AM PM

Month and Day*

and

Semester

Equipment for these days:

Repeat this request until:

Equipment needed:

Building and Room Location:

East Building Room

West Building Room

CIC Building Room

BSEL Building Room

Check this box if you don't have a room assigned at this time
But I will email media@tricity.wsu.edu you as soon as I get assigned a room

Please list special instructions or needs as well as any information not addressed above for your request:

If you are requesting multiple rooms, Please specify what equipment you need in each room.

Do you need instructions on how to properly run the equipment you have requested? Contact us at 372-7203 or media@tricity.wsu.edu about setting up a time to show you how to use the equipment

Please don't wait until 5 minutes before your event starts to ask for help

24 hours notice for all requests.
your procrastination does not constitute our emergency

I understand that in providing my name below that I understand I will take full responsibility for the safety and security of the equipment in the designated room/area. I understand that I am responsible for any damages to any of Washington State University's equipment during my organizations event. Furthermore, I acknowledge that I or my designee is responsible for returning the room to it's original condition when done.
I agree - Signed*

* = Required Fields

Media Services
Washington State University Tri-Cities, 2710 University Drive, Richland, WA 99354-1671 USA, Contact Us