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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:


Building:


Room:


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?
Yes    
No    

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    
Camcorder    
VCR    
Overhead Projector    
Video Recording    
CD Player    
PA System    
Speakers    
Audio Recording    
 

Microphone Needs:


Wired Podium Microphones - # needed:  

Lavaliere (Lapel) Microphones - # needed:  

Wireless Handheld Microphones - # needed:  


Detail any other media needs you require: