ARS Request Form


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ARS Request Form

ARS Request Form

Have you used the ARS system before?

Yes
No

Where would you like to use the system?

What type of course will you be using the system for?

Med1 Course
Med2 Course
Other Course

Dates, Times and Number of Clickers

(If you need more than 5 dates please contact Classroom and AV Services for assistance)

Name

Department

Phone Number

Additional Information

I have read and understand the ARS Policy.

Yes
No