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Media Services - Smart Cart Request Form

Name:

Office Phone:

Office Location:

Requested Date of Use:

MM/DD/YYYY

Requested Time of Use:

HH:MM am/pm

End of Use:

HH:MM am/pm

Class Located in:

Class Room:

Use in Main: Cart is to be picked up and returned by requestor at room 200A. (Media Service X2263)

Use in Zurn: Please call 881-3259 20 minutes prior to pick up of cart located in 117 Zurn. A staff member will meet you to release the cart to you.

Equipment is to be returned by requestir at specified END TIME. A no time is equipment to be left in classrooms.

You will be notified by phone and email of approval or denial of this request.

If you have any questions please contact Sharon Sisco at (x2263)

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