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2010 Conference AV/Computer Equipment Request Form

To be submitted to the Conference Director Andrea Shore and the MLA office, by December 18, 2009. All fields are required.

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 Requested - There is a Projection Screen in each room

Lavaliere Microphone
Overhead Projector
Flip Chart, If Yes, how many:
VHS Player
DVD Player
Video Projector
Laptop Projector (LCD Panel)
Internet Access
Laptop (PowerPoint, Excel, Word, Adobe Reader, Windows Media Player, Real Player, Flash)
Additional Equipment (Please enter items below)

Room Setup

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

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