Fillable Avt-tpf-10-12 Facility and Equipment Reservation Form

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Avt-tpf-10-12 Facility and Equipment Reservation Form

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(AV/TPF)
AV Technology/Theatre Use Planning Form
*Submit completed forms to Facilities Reservations – Zip 720 or SSC 110*
***Please Note: 10 working days advance notice required for each event – any changes must be submitted as an UPDATE.
Is this an ORIGINAL Request or an UPDATE ? Today’s Date:
Requestor: Grp/Dept: Phone:
Event Name: Event Date(s):
Facility Requested:
Event Time: to: (Facility Needed: to: )
Brief description of event and envisioned result:
EVENT/CLASSROOM MEDIA NEEDS
(*Tech Charges may apply with some services ~ Services only available 8am-5pm M-F unless overtime is approved and reimbursed.*)
Training - Audio Visual Technology:
Smart Classroom Pre-Event Public Address System
Public Address System (PA):
“
Self-Supported” Bose PA System – No Cost (3 Pieces: Main Speaker Unit, Speaker Extensions & Microphone/stand including RCA Cable,
Mini-Jack Cable, XLR Cable & Carrying Cases – please reserve via weblink http://www.csuchico.edu/tlp/services/equipment.shtml)
“Staff Supported” PA Systems can be delivered and set-up at the event location.
(CAF needed - $64,1 hr set-up/1 hr takedown @ $32/hr – Techs do not operate equipment for event. Additional charges may apply if an event
operator is needed.)
Microphones – How Many?
Type?
CD Player
Smart Classroom Video/Data Projector (some systems are on timers):
Built-In Computer – Hours needed: Laptop – Hours needed? Video Source – Hours needed?
Equipment:
Screen Portable Projector Laptop DVD Player
PAC Theatres & LAXS - Additional information needed for Theatre Use
I
f applicable: Rehearsal Day(s) & Date(s):
Rehearsal Time: to: Time Facility Needed: to:
Stage/House Lighting
Description:
Recital Set-up on Stage (submit floor plan):
Risers – How many?
Music Stands – How many?
Piano
Band Shell (LAXS only – portable)
Lecture Set-up on Stage (submit floor plan):
Table(s) – How
many?
Chair(s) – How many?
Lectern
Misc - Equipment (Tables & Chairs) or Services (Special needs Electrical, Custodial, HVAC)
– Please complete a Facilities and Equipment Request Form (FERF) @ http://www.csuchico.edu/fres
Other (please describe):
Please illustrate desired Stage set-up:
(Rear)
“STAGE AREA”
(Front)
*** Office Use Only ***
Approval for above request only – any changes will require submittal of an UPDATE and additional Approval:
ATEC_______ Date: _________
HFA_______ Date: _________ RCE_______ Date: _________ UPE_______ Date: ___________
Distribution: [ ] Event Calendar [ ] ATEC [ ] HFA [ ] RCE [ ] UPE
Last Updated 3/23/11
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Avt-tpf-10-12 Facility and Equipment Reservation Form

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Completed 22 March 2020

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