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2012 Conference AV/Computer Equipment Request Form

To be submitted to the Conference Director Carrie Willson-Plymire and the MLA office, by December 30, 2011. All fields are required.

Program Information

Program Title

Assigned Room

Day and Time

Program Contact

Contact Name

Email

Phone

Fax

Are you supplying your own equipment? Yes No If Yes, you are responsible for equipment storage.

Equipment - There is a screen, podium microphone, and Internet access in every room

Additional equipment needed for your program:

Lavaliere Microphone
Flip Chart, If Yes, how many:
Speakers
Table microphones for panel speakers, If yes, how many:
Laptop (PowerPoint, Excel, Word, Adobe Reader, Windows Media Player, Real Player, Flash)
Video Projector (laptop/DVD player)
Additional Equipment (Please enter items below)

Room Setup

Theatre Style (Default configuration. Provides maximum seating)
Banquet Style (round tables)
Classroom Style (narrow tables)

Please verify all information before submitting this form. Thank You.

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