University of the PACIFIC

Audio Video Equipment Order

Please complete the form below to request Audio/VideoEquipment.

You will be sent confirmation of your scheduled Audio/Video Equipment at the email address you provide.

Please Note: Only one form is needed, there is no need for each piece of equipment. Additionally, Audio/Video Equipment needs may need to be verified by your unit Technical Support Provider (TSP). Please verify first with your TSP before Submitting this form.

It is recommended that this form be submitted at least one week prior to the event to guarantee your equipment reservation.

Contact Information:
Department:
Phone:
First Name:
Last Name:
Email:
Event Information:
Building:
Room:
Start Date:
End Date:
Event Start Time:
Event End Time:
Setup Information:
CSC Set-up:	Customer Pick-up:
Equipment Requested:
Please check all equipment being requested. If your needs exceed the selections below, please contact the Customer Support Center at 209.946.7400
TV/VCR Combo:
PA System:
Data/Video Projector:
Overhead Projector:
Hand Held Microphone(Wired)
Hand Held Microphone (Wireless)
Lavalier Microphone (Tie Clip, Wired)
Lavalier Microphone (Tie Clip, Wireless)
70"x70" Screen
Microphone Stand
Table Top Microphone Stand
25' Microphone Cable
50' Microphone Cable
CD Player
Teleconference Phone
Handheld Digital Camcorder
DVI Camcorder
VCR
Additional Information: