JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Technology Equipment Request
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Have you completed a facilities request and submitted it to Judy Marcotte in Maintenance?
*
Yes
No. Please see the main office staff in the building for which you are requesting use to complete a paper Facilities Request Form
Contact information (name and email)
*
Your answer
Date you need technology
*
MM
/
DD
/
YYYY
Location (Please indicate building and room)
*
Your answer
Please select all equipment.
*
Microphone (please add a note if you need multiple)
Cable to connect laptop - Please indicate the cable type in the notes below (hdmi, usb-c). Please note that we do not provide adapters for apple computers.
projector
power strip
screen
Required
Additional information
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Merrimack School District.
Does this form look suspicious?
Report
Forms
