Equipment Request Form

Please copy and paste this information to submit your request. As noted below, you may submit either a hard or electronic copy of this form.

SEASECS 2010 Equipment Request Form

Presentation Title: _______________________________________________

_______________________________________________________________

Your Name: ____________________________________________________

Telephone: _____________  Fax: _____________ Email: _______________

Please provide the following information:

I will require the following presentation equipment:

LCD Projector and Screen
Computer
Microphone
Sound

I will require the following presentation equipment not listed above:

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

Please contact Dr. Judith B. Slagle if you have any questions or need more information.

All speakers are requested to complete this Request for Equipment Form by January 15, 2010, and return it to Dr. Judith B. Slagle, Department of English, East Tennessee State University, P. O. Box 70683, Johnson City, TN, 37601. We will do our best to accommodate your request.