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Special Events Media Request Form
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We respond to most requests within 24-48 hours of receipt of request either by phone or e-mail. Please be aware all event requests must be submitted at least 5 business days in advance.


--Items marked with a * are required to continue--
Submission Type:
   
Submitted by: *
Phone: *
E-mail: *
    
FOAPAL (optional):
Event Information:
     
Date of Event(MM/DD/YYYY): *
    
Location of Event: *
    
Event Start Time: *
    
Event End Time: *
    
Group/Event Name: *
    
Point of Contact Information:
 (if different from submitter's information)    
Contact Name:
Phone:
E-mail:
    
Media Equipment Requirements:
     
 
AUDIO
 
Portable Sound System    
Installed Sound System    
Microphone (wired), Qty:    
Microphone (wireless lapel), Qty:
Microphone (wireless handheld), Qty:
Stand, Microphone Floor/boom
Stand, Tabletop
 
VISUAL
    
Data/Video Projector
Screen
Notebook Computer, Mac, Qty:
Notebook Computer, PC, Qty:
TV/VCR
Slide Projector
Overhead Projector    
       
Additional Event Request Notes:
       
(Required) By submitting this form, you agree that the information submitted does not guarantee that the job request will be fulfilled until confirmation is sent to you from Media Services staff. You also agree that any and/or all equipment you submit with this request is not immediately reserved for your event or may not otherwise be available on the day of your event until confirmation is received from Media Services staff.

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Questions about this page? Please contact Matt Norwood at norwood< at >ucsc.edu.