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Media Services Request Form


Stark Media Services Request

Contact Media Services at 330-244-3572 or 53572 with any questions you have about your event.

Event Name:                                                          

Event Date:



Start Time:

End Time:

Event Coordinator:

Coordinator's Office Phone:

Coordinator's Cell Phone:

Student Organizations must complete this section:

Student Organization Name:

Advisor's Name:

Advisor's Contact Phone:


In-Person Media Services

Is an audio visual specialist needed at your event?

If yes, describe service needed:

If yes, what timeframe is the specialist needed?

Video, Audio & Projection Equipment

Check which video, audio and/or projection equipment is needed:

Video Projector    
TV & VCR    
Slide Projector    
Portable Screen    
DVD Player    
Overhead Projector    
Video Recording    
CD Player    
PA System    
Audio Recording    

Microphone Needs:

Wired Podium Microphones - # needed:  

Lavaliere (Lapel) Microphones - # needed:  

Wireless Handheld Microphones - # needed:  

Detail any other media needs you require: