Communication and Journalism Equipment 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 *
Requested Pickup Date: MUST be on a Friday or Tuesday Requested Pickup Date: MUST be on a Friday or Tuesday * / MM / DD YYYY
Requested Pickup Time: MUST be between 10:00am - 4:00pm on Tuesday, or 11:00am - 3:45pm on Friday. Requested Pickup Time: MUST be between 10:00am - 4:00pm on Tuesday, or 11:00am - 3:45pm on Friday. * : HH MM AM/PM
Requested Return Date: MUST be on the Tuesday directly following the Friday checkout or the Friday directly following the Tuesday checkout Requested Return Date: MUST be on the Tuesday directly following the Friday checkout or the Friday directly following the Tuesday checkout * / MM / DD YYYY
Requested Return Time: MUST be between 10:00am - 4:00pm on Tuesdays, or 11:00am - 3:45pm on Friday. Requested Return Time: MUST be between 10:00am - 4:00pm on Tuesdays, or 11:00am - 3:45pm on Friday. * : HH MM AM/PM
Class Selection:

Class Selection: Capstone JOUR 4800 JOUR 3750 JOUR 3420 JOUR 3100 COMM 1400

You must select the class for which this equipment is being used
Equipment Selection: Please make your selections based on your class/professor's requirements
CAMERA

Only 1 camera allowed per student/assignment.
Capstone Camera Kit

Capstone Camera Kit Journalism XF400 Kit: Canon XF400/XF100 camcorder, handheld mic, Rode shotgun mic, headphones, XLR cable, Vanguard flag, camera battery and power adapter
Capstone Canon XF400 Kit:
JOUR 4800 Camera Kit

JOUR 4800 Camera Kit Journalism XF400 Kit: Canon XF400/XF100 camcorder, handheld mic, Rode shotgun mic, headphones, XLR cable, Vanguard flag, camera battery and power adapter
4800 Canon XF400 Kit:
JOUR 3750 Camera Kit

JOUR 3750 Camera Kit Journalism XF400 Kit: Canon XF400/XF100 camcorder, handheld mic, Rode shotgun mic, headphones, XLR cable, Vanguard flag, camera battery and power adapter
3750 Canon XF400 Kit:
JOUR 3420 Camera Kit

JOUR 3420 Camera Kit T5 kit: w/ 18-55mm lens, two camera batteries and battery charger
3420 Canon T5/T5i:
JOUR 3100 Camera Kit

JOUR 3100 Camera Kit T7i/T5i/T3i kit: w/ 18-55mm lens, Rode shotgun mic, two camera batteries and battery charger
3100 T7i Kit:
COMM 1400 Camera Kit

COMM 1400 Camera Kit T7i/T5i/T3i kit: w/ 18-55mm lens, Rode shotgun mic, two camera batteries and battery charger
1400 T7i Kit:
Prime Lens Kit

Prime Lens Kit Rokinon 14, 24, 35, 85, 135
Zoom Lens

Zoom Lens Canon 24-70mm
CAMERA ACCESSORIES
AC Kit (slate, tool kit, gloves, marker, flashlight, colored tape)
MONITOR
CAMERA SUPPORT
Tripods

Tripods Small Manfrotto (for basic DSLR/camcorder set-up)
Small Manfrotto:
SOUND

Select only if additional items are required by the assignment, otherwise all camera kits already include mics.
Audio Kits

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

Additional Audio 2x Sennheiser wireless lavalier kit (one case) 4x Sennheiser wireless lavalier kit (two cases) Additional Shotgun mic w/ XLR cable N/A
Wireless Lavalier Kit:
LIGHTING
Flag Kit/Reflector

Flag Kit/Reflector Flag/Silk/Net Kit (convertible) Flex Fill 5-in-1 collapsible 24" x 36" Flag 12' x 12' Silk w/ frame (must request 2x additional combo stands and clamps separately) Survival Kit [Needs prior approval]
Lighting

Lighting Dracast 3 LED Panels w/ stands Arri 4 light kit (various sizes) 2x Ice Light with batteries Arri Sky Panel Other/special request (write in the space provided at bottom of form)
Light Stands
GRIP
C Stands
Combo Stands
Sand Bags
Stingers
Transport
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

Communication and Journalism Equipment Request Form

Communication and Journalism Equipment Request Form

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

CAMERA

Capstone Canon XF400 Kit:

4800 Canon XF400 Kit:

3750 Canon XF400 Kit:

3420 Canon T5/T5i:

3100 T7i Kit:

1400 T7i Kit:

CAMERA ACCESSORIES

MONITOR

CAMERA SUPPORT

Small Manfrotto:

SOUND

Wireless Lavalier Kit:

LIGHTING

GRIP

Transport