Make a service request

CONTACT INFORMATION

Name

Status Student Staff Faculty Other

Email Phone Cell Phone Department

Alternate Contact

If you will NOT be attending this event, please provide the name and cell phone number who will be present.

Alternate Contact Alternate Phone

BILLING INFORMATION

Please select the billing rate. Please see the explanation of our price structure for more information about which rate applies.

For a course meeting at Registrar's assigned time/place Course Number Student Group

Name of student group which is a

Campus Department or course outside of Registrar's assigned time/place

An account number, or payment by cash or check payable to Brown University is needed at least 24 hours before event.

Account number

Conference/Outside Rate

Payment is needed at least 24 hours before event, by cash or check payable to Brown University.

PURPOSE

Paint us a picture of your goals, objectives, etc. Check all that apply:

Show a PowerPoint Project video Speak to an audience Play audio - CD Play audio - computer Play audio - other source (iPod/Cassette)

Play video - DVD Play video - VHS tape Play video - computer Show a picture in a book Show a transparency

Record - self videotape Recording services - video Recording services - audio only Recording services - Auto Lecture Capture (Only Available HERE) Video conference Other Please specify

EQUIPMENT REQUESTED

VIDEO DISPLAYS LCD data projector Document camera Transparency projector Laptop - Mac Laptop - PC DVD Player VCR

AUDIO SUPPORT** Microphone - vocal performance Microphone - wireless handheld Microphone - wireless Lapel Microphone - panel Microphone - podium Microphone - Audience Q && A

**MTS only supports audio in these locations (click for list)

SPECIAL SERVICES Video conferencing System Web conference (WebEx) Web camera Video recording (MPG) (_Please complete this section_) NOTE: This service is NOT provided by Media Services. This information will be passed to MPG. You should contact them directly regarding your request. ) Other Please specify

STAFFING NEEDS

Are you using equipment installed in your classroom? at your event's location?

Not sure Yes, the equipment is already in the room No, the equipment needs to be brought to the room

Please select what staffing you will need from Media Technology Services (MTS). Staffing is subject to availability, and fees may apply.

Pickup and return by user: I will pick up and return equipment myself Deliver & Setup Only: I'd like Media Technology Services to deliver to set up the equipment and stay until the event class has started Unlock Only (no staff): I only need Media Technology Services to unlock the equipment (no MTS staff needed) To Start Event: I'd like Media Technology Services to set up to deliver or setup the equipment and stay until my class the event gets started Staff Entire Event: I'd like Media Technology Services to deliver set up to deliver or setup the equipment and stay for the ENTIRE event

AUDIO & VIDEO RECORDING AND EDITING (services coordinated and provided by Media Production Group)

Services listed here are NOT provided by Media Services. These services are provided by the Media Production Group (MPG). This information will be passed along to them. Please contact them directly for questions relating to your video/audio recording request.

No services needed Video recording services Video recording and live streaming Digital audio recording Automated Lecture Capture (ONLY available in: List120, Mac117, MetCalf Aud, Sal001, Sal101, SB106)

Delivery of recording via: DVD only Web BOTH Web and DVD Not sure/other

ADDITIONAL NOTES AND COMMENTS Please enter any specific requests or important information here.

Event info Event name Event Website or

Brown Calendar link

Location

You must schedule your room with the University Scheduling Office at 863-6217 Registrar's Office at 863-2500 before requesting Media Technology Services. We cannot reserve rooms for you.

Building Room

Event Time and Date Course Time and Date

Please note that reservations made fewer than TEN (10) Calendar days in advance of your event are subject a $150 rush processing fee and of your class may be denied.
Please provide the ACTUAL start time for your event. class. MTS will add the necessary set-up time before your event.

Event starts at: Date Time

Event ends at: Date Time

This event class will repeat . . .

Weekly Monthly Mon/Wed/Fri or Tue/Thu at this same time On specific days (please specify below) Please give end dates, exceptions (e.g. Spring Break, Fall Weekend), etc:

Submit your request

By submitting this form, borrower assumes full responsibility for the equipment and agrees to reimburse MTS for loss or damage.
All requests must be made with at least 10 calendar days notice.
All cancellations must be made with at least one (1) business days notice or subject to fees.
Video conferencing requests will receive a separate email requesting details of the call. This information must be completed and submitted 10 days prior to your event.
Requests made with fewer than 10 calendar days notice are subject to a $150 rush processing fee and may be denied.
MTS does not provide dongles/adapters for laptops.
MTS supports audio in some locations (click for list). For other locations, please contact Facility Management' Event Support Office at (401) 863-7820.
Requests sent Friday-Monday will not be processed until Tuesday of the following week.
MTS will contact you to confirm your request and provide you with a MTS confirmation number.
Some details of your request may change to conform to technical requirements, MTS policies, and security issues.

Please enter your initials to indicate you agree to Media Technology Services' terms and conditions: Submit your request: