Helen Hunt Elementary 

Name
Room #
Date
Time

Equipment information:

Equipment Type	Computer Document Camera Printer Telephone Overhead Television VCR Stereo Cassette player Listening Station Smart Board Data Projector Misc.
AV #
Date Needed (equipment check out)

Please rate this problem:

1.  Annoying

2. Unsafe

3. Cosmetic

4. Affecting Instruction

Detailed description of the problem:

 

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Media Center Use Only

Ticket #
Date Completed

What action was taken:

Do ourselves 

Call help desk

Support Center

Comments: