University of Rochester

Classroom Resource Request Form (ITF-041)

This is only a request for equipment and/or assistance in a classroom, not a confirmed reservation of these resources. Please review our reservation policies before submitting a request.

All academic departments that need to reserve space should contact the Registrar's Office at 275-5132 or 275-9828. Everyone else should contact the Wilson Commons Reservation Coordinator to reserve a room and Wilson Commons Event Support to request non-curricular audio/visual support. The IT Center also loans multimedia equipment for up to 3 days to Arts, Sciences and Engineering faculty, staff, and students.

Please complete this form in its entirety -- requests lacking information can not be processed.

Contact Information

* Your Name:
* Department:
* Your Phone Number:
* Your Email Address:
* Person(s) Responsible for Class:
* Their Phone Number:
* Their Email Address:

Scheduling Information

* Requested Start Date:
* Requested End Date:
* Day(s) of the Week:	Sunday Monday Tuesday Wednesday Thursday Friday Saturday
* Type of Class:
If class type is Other, please describe:
Course Number (CRN):
Building and Room Number:
Estimated Attendance:
Reservation Start Time:
Reservation End Time:

Equipment and In-class Technical Assistance

Equipment:	CD Player Data (computer) Projector Document Camera DVD Player VCR Overhead (transparency) Projector Portable Screen Slide (35mm) Projector Digital Video Camera (For Class Recording) Other
If Other is selected above, please specify:
* Do you need technical assistance in the classroom?:	YesNo
Will the equipment be picked up, or would you like it delivered?:	DeliveryPick Up

Comments or Special Requests

Please use this space to share your comments or describe any special needs:

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Classroom Resource Request Form (ITF-041)