AV Equipment Borrowing Reservation Form

Please note: There is a limited supply of portable AV equipment
(for internal use only)

Applicant Identification Section
    *Denotes required entry
Name: *
Name of meeting (ie: Lab meeting, Neurology Rounds)

* Info?

Institution: * 
Department: *  Room Number: *
Telephone#: * 
Email Address: *
MUHC Cost Centre Number:
Notice: Required by MUHC Staff

See Rental Price List
Applies to MUHC for Rental Fees.
   For others please call (514)398-5767
Please Note:
AV Service counter
is open from
9am to 4:30pm.
Equipment Borrowing Date(s) and Times
Pickup Date: *è
Please select date by using the above calendar
Pickup Time: *
Return Date: è
Please select date by using the above calendar
(Please ignore if returning the same day)
Return Time: *
Standing Reservations (Maximum 6 month in advance)
Please enter the starting date above first!     see calendar utility
Month Choose Related Dates Year Comments

AV Equipment Required?
(for internal use only)

Computer Projector
Other AV Equipment
Used in what room: *

Any other pertinent
information or requests.

Please Note: If you require an installation
please call (514) 398-5767 to make support reservations!

Secondary Support (514)398-3193