Equipment Request Form

This order form is only valid when a verification e-mail is returned to you from TS. All requests require 3 working days prior to the event. Use is limited to Missouri Western faculty and staff for Missouri Western classes and events only. All equipment will be setup/delivered during the setup/delivery time you indicate.

Your Information

Name: Email:
Phone: Today's Date and Time: 6/2/2023 3:39:35 AM

Delivery Information (If Applicable)

Event or Class Name:
Date of Delivery:
Requested Setup/Delivery Time:
Actual Time of Event:
Building/Room to be Delivered to:
Date for the equipment to be retrieved:
Time for the equipment to be retrieved:

Presentation Equipment

Check Out Equipment Quantity Training Needed
Portable Video Projector
Easel for flip chart pad
Dry Erase Easel
Portable Screen
Transparency Projector(Overhead)
PC Laptop
Wireless Mouse (Clicker)
Web Cam
Zoom Conference Cart
Conference Camera
Conference Phone
Document Camera
Bluray Player/DVD Player
Wired Microphone/Table Top Stand
Wired Microphone and Tall Stand
Wired Podium Microphone
Wireless Lapel Microphone
Wireless Handheld Microphone
Small AV Cart
Classroom Services DOES NOT provide consumables such as easel paper, dry erase pens, erasers, tapes, etc.

**If an Internet connection is needed for a device that has not been used recently on Missouri Western's network you must contact IT to register the device before it can access the network.

Please outline special instructions for presentation equipment set-up.
If training is needed, please indicate desired training time:
Indicate the number of technicians needed (if necessary):
If Technician(s) necessary, please indicate times needed: to

Technician fees are $10.00 per hour/per technician for all activities not directly related to a Missouri Western Credit or non-credit class. Technicians must be requested 10 working days prior to the event.