CIS MEDIA & ACS VIDEO SERVICES RESERVATION FORM

Please use this form to create a request for TC auditorium setups, smart classroom setups,video editing suites, and all audio and video equipment loans.We will email you to confirm your request within 24 hours. Please submit your request at least 2 business day in advance of expected use. If you have any questions about Media and its services please call CIS Media Services at 212 678 3822. If you have any questions about video and its services please call ACS Video Services at 212 678 3359.

Client Information:

First Name:

Last Name:

Email:

Course Number:

Phone:

Department:

Comments:

Department:

Please check Department request is directed to:
CIS Media ACS Video

Delivery Information:

From Date:

mm/dd/yyyy

To Date:

mm/dd/yyyy

From Time:

To Time:

Initial Action:

End Action:

Deliver To:

Pickup From:

Schedule Information:

If you are making a Recurring Order, you must specify a Starting Date for when the cycle begins and an Ending Date for the cycle to terminate.Please keep in mind you must create a reservation request for each day of the week, for example if you have a Monday and Wednesday class at 4:30pm first create your Monday request and submit the completed form and then click on the Media Manager Request link and reenter the info for your Wednesday class.

One Time Only

Daily

Weekly

Every

Monthly

The

of the month(s).

Starting Date:

mm/dd/yyyy

Ending Date:

mm/dd/yyyy

Basic Equipment Information:

	Quantity:	Department:	Category:
1.
2.
3.
4.
5.

Notes: