Instructional Media Services

Equipment and Event Support Request Form

Time Period:

MM/dd/YYYY (ex. 01/23/2021)

MM/dd/YYYY (ex. 01/23/2021)

Is This a Recurring Event?

Yes

Campus Information:

Check here if you need help in using this equipment

Special Notes or Requirements:

Contact Information:

First Name

Last Name

Complete IU Northwest email address

4 Digit Campus Phone Extension