Media Request Form

Media Reqest Form: Event Set Ups

Personal Information

Your Name:

Your Affiliation w/GCC

Faculty Student Staff Other

Phone:

Email Address:

Department or Student Organization / Club

Department Chair or Club Advisor

Details of Request

Campus: Main North

Setup Date:
Must use mm/dd/yyyy format (ex. 02/14/2008)

Program or Event Title:

Delivery/Setup Time: Must use am/pm (ex. 3:00 pm)

Pickup/Tear-down Time: Must use am/pm (ex. 4:00 pm)

Location (bldg. and room OR exact campus location)

Equipment Requested:

Any comments or additional information

A media technician will contact you regarding your request.

This form is to be used to request special set ups by the Library Media Department for events requiring media equipment only. Please complete the information requested. If you have questions, contact the Media Department, 623.845.3119.


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John F. Prince Library - Glendale Community College - 6000 West Olive Avenue - Glendale, Arizona 85302 - 623.845.3109
Library & Computer Center - Glendale Community College North - 5727 W. Happy Valley Rd - Glendale, AZ 85310 - 623.845.4109
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Modified: Modified: April 18, 2009