Carroll Community College
Library Audiovisual Media/Equipment Request Form
Please use one form per course.
*Fields marked with an asterisk are required.
Please verify that all required fields have been filled-in before submitting the form.
The earlier a request is submitted the greater chance it can be delivered.
If unable to contact media, please contact the circulation desk
in the library for media requests.
*
Instructor:
*
Work Phone:
Home Phone:
*
E-mail address:
*
Date Needed:
year
2030
2029
2028
2027
2026
2025
2024
month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
*
Time - beginning and end:
*
Course No./Section
*
Days course meets:
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
*
Room number:
*
Semester loan?
Yes
No
Equipment Required- Delivered
*
If no equipment is required for delivery, please select
"NONE"
NONE
Multmedia Cart (includes computer, speakers, and projector)
Video Projector (HDMI and VGA)
Easel
Easel/Paper/Pens
Overhead Projector
VR Cart – Classroom session (Please request with at least two weeks advance notice. Provide desired VR application in ‘Other Instructions')
Equipment Required- Faculty Pickup/Return
*
If no equipment is required for pick-up, please select
"NONE"
NONE
HD Sony Handycam Video camera
Interwrite School Pad
Wireless Presenter
USB Microphone
TurningPoint Response Set (32 pads)
TurningPoint Response Set (48 pads)
Audiocassette Player/Recorder
CD Player
Blu-Ray Player
Camcorder
Cam Tripod
Travel-Ready LCD Projector
Remote
Instructional Materials Required.
Note: Instructional Material is delivered to classroom.
Other Instructions:
Please review your request before submitting.
You will receive a confirmation from Media Services after your request has been entered on the schedule.
Media_Requests@carrollcc.edu