AUTHORIZATION FORM FOR INSTRUCTIONAL TECHNOLOGY EQUIPMENT

Authorization form for a student  to use media and/or equipment
 on the Marywood Campus:

Please arrange for _________________________________________
(student)

to use ___________________________________________________
(media)                    (call no.)                 (title)

equipment________________________________________________

in my class __________________________­­­­_____________________
(course title)

on ______________________________________________________
(date)

from (time) _____________ to ________________

I understand that the material will be returned after class.

_________________________________________
(Instructor/Advisor/Supervisor)