Equipment Checkout Form – Other Fill out this form at least 24 hours in advance of when you intend to check out equipment outside of newsroom hours. Name: E-mail: Course: JRN Date of shoot:---JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember ---12345678910111213141516171819202122232425262728293031 Time of shoot:---1 a.m.2 a.m.3 a.m.4 a.m.5 a.m.6 a.m.7 a.m.8 a.m.9 a.m.10 a.m.11 a.m.12 p.m.1 p.m.2 p.m.3 p.m.4 p.m.5 p.m.6 p.m.7 p.m.8 p.m.9 p.m.10 p.m.11 p.m.12 am. to ---1 a.m.2 a.m.3 a.m.4 a.m.5 a.m.6 a.m.7 a.m.8 a.m.9 a.m.10 a.m.11 a.m.12 p.m.1 p.m.2 p.m.3 p.m.4 p.m.5 p.m.6 p.m.7 p.m.8 p.m.9 p.m.10 p.m.11 p.m.12 am. Description of event & special notes: Equipment:Nikon D7100 kit (JRN320/215 stills/video DSLR)JVC GY-HM150U (JRN371/370 video camera)JVC Everio small video camera (JRN310 camera)Zoom H2 Audio RecorderBroadcast TripodSmall video/Nikon TripodNikon 16-35 f/4 lens (JRN380 only)Nikon 35mm f/1.8 lens (JRN380 only)Nikon 50mm f/1.4 lens (JRN380 only)Nikon 85mm f/1.8 lens (JRN380 only)Nikon 105mm f/2.8 Micro Lens (JRN380 only)Nikon 70-200 f/4 lens (JRN380 only)Nikon SB-700 flash (JRN380 only) * Sony V1U kits include: wireless stick mic/receiver, lav w/extension, 2 batteries, headphones, charger, firewire.* JVC GY-HM150U kits include: wireless stick mic/receiver, wireless lav, 1 battery, headphones, charger.* JVC Everio kits include: USB cable, charger, stick mic, shotgun mic.* Nikon kits include: Stick mic (Must ask for Lavalier or Shotgun mics), charger, 1 battery.* Zoom H2 audio recorder includes: memory card. Where will you store equipment? (See note 1* below): Weekend checkouts are Friday through Monday only. No checkouts after 5 p.m, Monday-Thursday. No checkouts after 3 p.m. on Friday. Check equipment room door for equipment check-in/check-out hours Sat/Sun(CLOSED) Pick up your overnight camera by 3pm. All overnight cameras are due by 10am. Do not request check-in or check-out outside of these hours. When will you check out the equipment? ---JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember ---12345678910111213141516171819202122232425262728293031 at ---8 a.m.8:30 a.m9 a.m9:30 a.m10 a.m10:30 a.m.11 a.m11:30 a.m12 p.m.12:30 p.m.1 p.m.1:30 p.m.2 p.m.2:30 p.m.3 p.m.3:30 p.m.4 p.m.4:30 p.m.5 p.m.5:30 p.m.6 p.m.6:30 p.m.7 p.m.7:30 p.m.8 p.m. When will you return the equipment? ---JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember ---12345678910111213141516171819202122232425262728293031 at ---8 a.m.8:30 a.m9 a.m9:30 a.m10 a.m10:30 a.m.11 a.m11:30 a.m12 p.m.12:30 p.m.1 p.m.1:30 p.m.2 p.m.2:30 p.m.3 p.m.3:30 p.m.4 p.m.4:30 p.m.5 p.m.5:30 p.m.6 p.m.6:30 p.m.7 p.m.7:30 p.m.8 p.m. 24-hour Advance Notice PolicyThis form has been submitted 24 hours before I intend to check out the equipment.---yesno If not, please explain why / reason for special request: *Note 1: Cameras may not be kept in dorms overnight. If you live on campus and want to borrow a camera on weekends or overnight, you must lock it in one of the newsroom lockers when you are not using it. Cameras should never be left unattended; never leave a camera in a car trunk. Note: No check-in or check-out on weekends, holidays or when the university schedules no classes. No cameras may be kept overnight without prior email approval of your instructor after receiving this form. All cameras and accessories must be returned together. If any camera or accessory is missing or broken, student must alert his/her professor immediately. Cameras may never be left unattended anywhere including the newsroom, dorms, cars, etc. Any request by a student who does not follow the instructions will be automatically denied. You will be held financially responsible for lost, damaged or stolen equipment. Failure to follow any of these policies will result in a suspension of after-hours equipment privileges.