AV Rental Form

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Billing Information

Company Name* :

Contact Name* :

Address 1* :

Address 2 :

City* :

State* :

Zip* :

Phone Number* :

Extension :

Fax Number* :

E-mail Address* :

Date of Info Session* : / /

Start Time* : : /

End Time* : / /

Location* :

AV Rental Equipment Package

This is the basic charge for AV equipment rental and includes the items listed below. You must check which equipment you will be using for your presentation. All classrooms contain this equipment, but only items checked will be set-up prior to your Information Session by the Instructional Technology staff.

NOTE: AV Late & Cancellation Fees: Less than 24 hrs ($20.00), Less than 4 hrs ($35.00), Less than 1 hr ($50.00)

I plan to:

Show a Video
Use an Overhead Projector
Use a Chalkboard
Show a Power Point Presentation:

Basic AV Charge : $150.00

Additional AV Equipment

In addition, I need to:

Show a slide presentation $25.00
Use an easel and marker pad $30.00
Play a DVD $50.00
Use a clip-on microphone $35.00

(Suggested for sessions with more than 75 attending only)

Use videoconferencing $250.00 ($250 for the first hour and $50 for each additional hour)

Total for Additional Equipment

GRAND TOTAL

Notes

Please include any information which did not fit in the form