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"""""".4"COUNT,, PUBLIC USE OF TRAINING CENTER <br /> PV 11 Media Request Form - Auditorium <br /> PUBLIC UTILITY DISTRICT Nu_I <br /> T' �,,,,�� <br /> Name of Applicant: L l IN _ 1/4);_,we <br /> jai o sa/\. <br /> Date(s)of Event: OCftAX.rZ j 2 , 2 U (-1 <br /> Daytime Phone Z 25 Z 5 7' 7)61 S Email: j [ (el Sc.f'l C11L wG( •Jot) <br /> Cell Phone26 j - ?)60 -.3�31 <br /> EQUIPMENT(please check all equipment items you are requesting): <br /> ❑ Easel:Number of easels* <br /> *PUD does not supply easel pads or markers for outside groups <br /> MULTIMEDIA(please check all that apply): <br /> Projection <br /> Will you be using: 1M:Laptop ❑ Desktop ❑ Other device? <br /> Operating system: .a Windows ❑ Mac(requires a user provided adapter) ❑ <br /> Other <br /> Resolution of your device: 'Don't know <br /> What laptop connection port do you typically use? p'VGA) HDMI ❑ DisplayPort❑ Other <br /> PUD provides the following connections:VGA-15pin,HDMI and DisplayPort. <br /> Note:PUD does not provide adapters that may be needed to connect your device to the connection. <br /> ❑ Will you need sound from your laptop or other device amplified through the room sound system? <br /> IK'Video Projection Type(check all that apply for this event) <br /> Format: Ci.PowerPoint ❑ Blu-Ray❑DVD ❑Movie from video file on laptop ❑ Other <br /> ❑ Wireless Internet(You will need to have a guest wireless access code) <br /> PUD recommends testing your equipment prior to the event. This can be arranged by contacting the PUD Training <br /> Center Reception Desk to schedule an appointment. <br /> SOUND ACCESSORIES(These apply to Training Center Auditorium only.Please check all that apply): <br /> VO Lectern(podium)microphone <br /> ❑ Regular microphone on microphone stands: Quantity (maximum 4) <br /> ❑ Regular microphone on table stands: Quantity (maximum 10) <br /> ❑ Wireless handheld microphones: Quantity (maximum 3) <br /> ❑ CD player through Auditorium sound system <br /> I,( t'4- <br /> i4 ,(User)agree to be responsible for replacement or repair to like <br /> conition before my use,of any equipment damaged by misuse or abuse during my rental period. <br /> COMMENTS OR SPECIAL INSTRUCTIONS g Check and please write on the back of this form <br /> Please refer technical questions to the Training&Technology Center Coordinator at 425-783-8458 <br /> (email questions to jrschuler@snopud.com). <br /> FOR PUD STAFF: <br /> ❑Verify availability of equipment and inform technician of equipment requested <br /> ❑Microphones only for auditorium <br /> FOR TECHNICIAN:If additional equipment is used,please notify Training Center Receptionist for customer invoicing <br /> Page 8 <br /> REV:4/17 <br />