...................... Instructor Media Request

Name: Email:

Is it OK to communicate with you by e-mail? Yes ...... No

Name of Course: Location:

Begins on (date) Ends on (date)

I will need access to a computer for my class (or for one of my visiting speakers).
(You will need to pick up information on your user name and password from the OLLI office
before your first class. Driver License Number required:

I will need training to use the equipment.


I will need the following equipment:
Computer/Document Camera/Screen (The document camera also doubles as an
overhead projector.

DVD player

CD player

TV/VCR

Slide Projector

Overhead projector

Other:

Which is the best way to communicate with you?

......E-mail

......Phone

......US Mail


Other questions or concerns?

Presss the SUBMIT button
This form to is submitted to Barbara Mallon
Furman University - OLLI
(864) 294-2998

If you have any questions, contact Barbara.mallon@furman.edu