Group/Event Name:		Event/Date Time:
Group/Event Leader:		Phone:
		Email:
Facility Room:

Start Date:

End Date:

Providing audio/visual equipment and services for your event is not a small thing.  We must purchase, maintain, and train our volunteer ministry team to operate some very expensive equipment in order for your event to be presented with a certain standard of excellence.  We also need to confirm that properly trained technicians are available to support you should you request equipment that requires such support.  The hourly rate for technicians to set up and run the event is $25/hr. These fees will be waived for HSBC sponsored events.  In order to be good stewards of both human and equipment resources, HSBC requires an Audio/Visual equipment request policy and procedure.  This form is the main information tool to execute the proper request procedure.

All requests will be processed on a first-come, first-served basis.  The following is simply a request form.  All the items and technicians are subject to availability.  The Facility Use Coordinator will contact you if we are unable to meet your request.  All requests are required by the Facility Use Coordinator 30 days prior to your event.  Please refer to the Facility Use policies and procedures for more detail.

Check Need	Item	Tech Required?
	Small Portable Audio Package:  (2) main speakers w/stands, (2) mics, (2) mic cords, 25', (1) mic stand w/ clips, (1) powered mixer w/ 6 channels, (1) electrical cord	Setup-Yes
	Medium Portable Audio Package: (2) main powered speakers w/ stands, (1) rolling case with mixer, CD/Tape playback, EQ, Power Distribution, (10) 25' mic cables, (1) 50' mic cable, mic cases w/ 3 direct boxes, (4) SM58 mics, (4) mic stands, electrical box with two 50' cords, (6) 3-ways, 100' electrical cord	Setup-Yes
	Large Portable Audio Package:  (4) Main Powered Speakers with stands, (1) Rolling case with Mixer, CD Playback, EQ, Compressor, Wireless HH, Mic bag with (4) Mics, (2) Direct Boxes, (4) Mic Stands, Mic Cord Box with (6) 50' cords, (4) 25' cords, Elect Box, (4) 3 ways, (1) 15' cord, (3) 100' cords, (1) powered sub, (4) Boom Mic stands	Setup-Yes Event-Yes
	Gymnasium Audio Package:  (2) 18” main speakers mounted, (1) 8 channel audio mixer, (1) 8 channel snake mounted, (1) CD/cassette playback, (no additional audio/visual equipment available unless requested)	Setup-Yes Event-Yes
	Chapel Audio/Visual Package:  8” overhead speakers throughout, (3) 12” floor monitors with aux send, (1) wireless handheld mic, (1) wireless lapel mic, (1) 12 channel audio mixer, (1) CD/cassette playback, (1) VHS/DVD playback,  (1) computer for power point/CDROM, (1) mounted projector	Setup-Yes Event-Yes
	Worship Center Premium A/V Package with Personnel:  Requires (1) audio tech, (1) lighting tech, (1) IMAG video tech	Setup-Yes Event-Yes
	Video Editing Suite:  (1) G4 multimedia workstation, (1) Sony mini-DV editing deck, (1) Panasonic DVD burner	Only trained techs
	Portable Video Camera Package: (1) Canon Elura, (1) battery	Only trained techs
	Premium Video Camera Package:  [must be used on HSBC site only]  (1) Canon GL-2, (2) batteries, (1) Sennheiser wireless lapel mic for camera	Only trained techs
	Portable Camera Tripod – Bogen	Only trained techs
	Portable backdrop package:  (1) grey 8’x12’ cloth backdrop, (2) extension stands, (1) backdrop cross bar	Only trained techs
	Premium Portable Lighting Package:  [for use with video shooting both on and off site] (1) Arri 4 piece lighting set with stands and soft goods	Only trained techs
	Portable Video Projector Package:  (1) Video projector with pelican case, (1) VGA cable, (1) remote [OFF-SITE Capable for HSBC Activities ONLY]	Setup-Yes Event-No
0123	Basic Video Presentation Package:  (1) TV monitor, (1) VCR playback, (1) DVD playback, (1) portable media cart [max 3 units available]	Setup-Yes
	Deluxe Video Presentation Package:  (1) Video projector with pelican case, (1) VCR playback, (1) DVD playback, (1) laptop PC for power point [CD-ROM only], (1) VGA cable	Setup-Yes
0123	Basic Overhead Projector Package (Transparency):  (1) overhead projector, (1) portable media cart [3 units available]	Setup-Yes
	Portable 6’ Projector Screen	Setup-Yes
	Portable CD/cassette player (boom box type)	Setup-Yes
0123	Additional handheld microphone w/ stand	Setup-Yes
	Wireless lapel microphone	Setup-Yes
	Wireless handheld microphone	Setup-Yes
	Additional floor monitor speakers	Setup-Yes
	16 Channel Snake: (1) 16 Channel 4 return Snake approx 100' long	Setup-No
	Extra Mic Stands: (2) Boom Mic Stands, (1) Mic Stand short, (1) Guitar Stand	Setup-No
	Monitor Amp Rack: (2) floor monitors, (1) Amp Rack with Peavey Amp, (2) 25' speaker cables	Setup-No
	Audio recording – includes 1 master / duplicates $2.00 ea, CD Master available ONLY in Worship Center	Setup-Yes Event-Yes
	Please indicate total number of A/V Personnel you believe are needed, based on ALL packages above	Setup-Yes