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Event Services Request

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Event Services Request

Information Technologies

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Note: If the location for your event is not listed in the form below, please use the Classroom Services Request Form.

Contact Information First Name: Required

Last Name: Required

Phone Number: Required

() -Second partThird part

email address: Required

Affiliation: Required

Event details Event Title: Required

Location (if the location for your event is not listed below, please use the Classroom Services Request Form): Required

Event Date: Required

Date and time

Preferred Setup Time:

Event Start Time: Required

End Time: Required

Estimated Audience Size: Required

FUAC Number:

Is this event specifically for a UWB credit-Generating Course?: Required

yes
no

What is the event orientation?: Required

Audio Services Number of Microphones needed:

Compact Disc (CD) player?:

Connection for another audio device (MP3 player, etc.):

If so, please describe audio device:

Video Services Please select all media types you plan to display during your event:

DVD
VHS
Paper Documents (Document Camera)
Transparencies (overhead projector)

Computer Services Please select any computer related video you plan to display:

PowerPoint slides
internet video
computer video files (.wmv,.mpeg,etc.)
computer software

Do you plan to use your own laptop computer for the presentation?:

Miscellaneous Number of Easels Needed:

Will you need paper pads with the easels?:

Will you need a podium?: Required

yes
no

Additional Notes Are their items not listed that you would like us to provide? Please list below:

Please Acknowledge You should not consider your request as "completed" until you receive an official confirmation email from an I.T. staff person. If you do not receive an official confirmation email at least five business days prior to your event, call I.T. immediately.: Required

The ability to support this request is dependent upon the availability of I.T. personnel and equipment.: Required

Did You Know?

UW Bothell offers classes in Bellevue, Everett and Mount Vernon.

Big W

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Information Technologies
Box 358500
18115 Campus Way NE
Bothell, WA 98011-8246

Phone: 425.352.3456
Fax: 425.352.5455
TDD: 425.352.5303
Email: it@uwb.edu

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