Audio Production Equipment & Audio Suite Request Form

Student name Student name * First Last
900 number *
Student cell phone Student cell phone * - ### - ### ####
UNG email *
Today's Date Today's Date * / MM / DD YYYY
Instructor Name *
Assignment Name *
Audio Suite Reservation Required? *

Audio Suite Reservation Required? Yes No

If equipment is requested, it will only be available during the time approved for Audio Suite reservation. If equipment is needed for longer, a separate form must be submitted.
Requested Audio Suite Reservation Date: Requested Audio Suite Reservation Date: * / MM / DD YYYY

(Must be Monday - Friday)
Requested Audio Suite Reservation Start Time: Requested Audio Suite Reservation Start Time: * : HH MM AM/PM

(in 2-hour increments) beginning at 10am-- last reservation start time is 4pm.
Requested Audio Suite Reservation End Time: Requested Audio Suite Reservation End Time: * : HH MM AM/PM

(in 2-hour increments)-- last reservation end time is 6pm.
Requested Equipment Pickup Date: Requested Equipment Pickup Date: * / MM / DD YYYY

MUST be on a Tuesday or Friday.
Requested Equipment Pickup Time: Requested Equipment Pickup Time: * : HH MM AM/PM

MUST be between 11:00am - 5:00pm on Tuesday, or 11:00am - 4:00pm on Friday (in 30 minute increments)
Requested Equipment Return Date: Requested Equipment Return Date: * / MM / DD YYYY

MUST be on the Tuesday directly following the Friday checkout or the Friday directly following the Tuesday checkout (if not returning the same day)
Requested Equipment Return Time: Requested Equipment Return Time: * : HH MM AM/PM

MUST be between 11:00am - 5:00pm on Tuesday, or 11:00am - 4:00pm on Friday (in 30 minute increments)
Equipment Selection: Please make your selections based on your class/professor's requirements
SOUND

Select only one mixer kit
Audio Kits

Audio Kits Audio Kit: Tascam DR60d MKII Mixer/Recorder w/ power supply, Rode NTG2 Shotgun Mic, headphones, XLR cable, and boom pole Sound Devices 633 Recorder/Mixer (w/ headphones, XLR and Shotgun Mic) [Special Permission Required] Sound Devices 552 Recorder/Mixer (w/ headphones, XLR and Shotgun Mic) [Special Permission Required]
Tascam Sound Kit:
Additional Audio

Additional Audio 2x Sennheiser wireless lavalier kit (one case) 4x Sennheiser wireless lavalier kit (two cases) Additional Shotgun mic w/ XLR cable Boom Buddy (Special Permission Required] Additional XLR Other Other
2x Sennheiser Lav Kit:
4x Sennheiser Lav Kit:
EXTRA boom, mic, shotgun and shock mount:
Boom Budy:
CAMERA/MIXER SUPPORT
Tripods

Tripods Small Manfrotto
GRIP

Apple Boxes:
( Note: For 'Full' set, the maximum allowed quantity is '3' )
	1	2	3	4	(0)
Full	Full1	Full2	Full3	Full4	Full(0)
Half	Half1	Half2	Half3	Half4	Half(0)
Quarter	Quarter1	Quarter2	Quarter3	Quarter4	Quarter(0)
Pancake	Pancake1	Pancake2	Pancake3	Pancake4	Pancake(0)

C Stands
Sand Bags (on campus use only)
Stingers
Transport
Carts

Carts RocknRoller Multicart RocknRoller Multicart w/ shelf Camera Cart (on campus use only)

Only one cart per production
Special Request/Other

Please use this space to indicate a special request or to modify an amount or listed package above
Draw your signature into the box below. *

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Approval - This is only for Equipment Manager - DO NOT FILL

Approval - This is only for Equipment Manager - DO NOT FILL Approved Need to Resubmit

Clamps	1	2	3	4	(0)
Cardellini	Cardellini1	Cardellini2	Cardellini3	Cardellini4	Cardellini(0)
Duckbill	Duckbill1	Duckbill2	Duckbill3	Duckbill4	Duckbill(0)
Mafer	Mafer1	Mafer2	Mafer3	Mafer4	Mafer(0)
Scissor/Drop Ceiling	Scissor/Drop Ceiling1	Scissor/Drop Ceiling2	Scissor/Drop Ceiling3	Scissor/Drop Ceiling4	Scissor/Drop Ceiling(0)

Audio Production Equipment & Audio Suite Request Form

Audio Production Equipment & Audio Suite Request Form

Equipment Selection: Please make your selections based on your class/professor's requirements

SOUND

Tascam Sound Kit:

2x Sennheiser Lav Kit:

4x Sennheiser Lav Kit:

EXTRA boom, mic, shotgun and shock mount:

Boom Budy:

CAMERA/MIXER SUPPORT

GRIP

Transport