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Center for Support of Instruction

Office of Instructional Services and Support

Request CSI Services/Reserve the Media Lab (SFSC 1226)


Contact Information

*Full name:
*E-mail: *Phone number:
*Department:
  Course:     Anticipated # of students per semester:
* indicates required information

Please tell us about your project/task.

Brief description:

Purpose/scope (expected longevity, reusability, public Web / private classroom use, etc.):


CSI services being requested (check all that apply):

Project consultation and analysis
Tutorial or instruction set development
Video/audio recording, editing, and encoding
Course quality review
Demonstration or presentation
Instructional object development
Web/multimedia design or programming
Class visit
Training
Request Reservation to use Media Lab (SFSC 1226 -- Note: Confirmation of Lab availability will be sent prior to requested date):

Date:

Time:

Intended Use:

Other (please describe):


Desired project/task completion date:


Additional information regarding your request:


Please tell us how you learned of CSI's services (optional):


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