NATICK PEGASUS                            

2 SUMMER ST. NATICK, MA 01760

TEL: 508.651.0022 n FAX: 508.651.1285 n EMAIL: INFO@NATICKPEGASUS.ORG

 

PORTABLE EQUIPMENT REQUEST FORM

 

NAME:_____________________________TEL:__________________DATE:______________

 

PROJECT / SHOW:_____________________________________________________________

 

DESTINATON:________________________________________________________________

 

PICK UP TIME / DATE:___________________RETURN TIME /DATE:__________________

 

PLEASE HAND THIS REQUEST FORM INTO THE STATION MANAGER AT LEAST 24 HOURS PRIOR TO USE OF THE EQUIPMENT. NOT ADHERING TO PICK UP TIME AND DROP OFF TIME MAY LEAD TO FORFEITURE OF EQUIPMENT USE. ALL EQUIPMENT IS RESERVED ON A FIRST COME FIRST SERVE BASIES. SOME EQUIPMENT ON THIS LIST IS FOR STAFF USE ONLY.

 

CAMERAS

ÿ SONY DSR-370/ 390 DVCAM #     ÿ  ENG #1, ÿ  ENG #2, ÿ ENG #7

ÿ VEWFINDER #___    ÿ POWER ADAPTOR #___

 

ÿ SONY DSR-250 DVCAM #     ÿ  ENG #3,  ÿ  ENG # 4

 

ÿ CANON XL-1 MIN DV #      ÿ  ENG # 5,  ÿ  ENG #6

ÿ POWER ADAPTOR #___ VARIZOOM CAMERA CONTROL#___

ÿ CANON GL-1 MIN DV #___ 

  ÿ POWER ADAPTOR #___

 

ÿ BATTERIES#     ÿ AA,  ÿ BB,  ÿ  CC,  ÿ DD, ÿ  EE,  ÿ  FF,  ÿ GG,     ÿ A,  ÿ B,  ÿ C,  ÿ D,  ÿ E,  ÿ F,   ÿ  G,  

                                   (SONY)                                                                   (CANON)         

AUDIO

 

ÿ HAND HELD MIC #___.

ÿ SHOTGUN MIC.  #___

ÿ LAV. MIC. #___

ÿ HEADSET/MIC (ANNOUNCERS HEADSETS) #___

ÿ HEADPHONE #___

ÿ DIRECT BOX#___

ÿ HUM ELIMINATOR#___

ÿ XLR AUDIO CABLE Yellow 100’ #___

ÿ XLR AUDIO CABLE RED 50’ #___

ÿ XLR AUDIO CABLE BLUE 25’ #___

ÿ XLR AUDIO CABLE GREEN 10’ #___

ÿ XLR TO TS 1/8” #___

ÿ XLR TO TRS 1/4” #___

ÿ XLR TO RCA #___

 

AUDIO CONTINUED

ÿ RCA TO RCA#___

ÿ XLR-Y  #___

ÿ XLR F TO F BARREL #___

ÿ XLR M TO M BARREL #___

ÿ MACKIE 1402-VLZ#___

ÿ SHURE MIXER (4 CHANNEL) #___

ÿ FLOOR MIC. STAND #___

ÿ DESK MIC. STAND #___

ÿ BOOM MIC. STAND #___

ÿ AZDEN WIRELESS KIT  #1 (GREEN)

ÿ AZDEN WIRELESS KIT #2 (RED)

ÿAZDEN WIRELESS KIT #3 (WHITE)              

ÿ SHURE WIRELESS KIT #___

    BODY PACK, RECIVER

 

 

 

 

 

 

VIDEO MONITORS

ÿ PANASONIC BTS 700 #___

ÿ JVC TM 22U #___

ÿ JVC TM9105V#___

ÿ VERIZOOM LCD KIT#___  ÿ BATTERIES #___  ÿ POWER ADAPTOR #___ ÿ  MOUNTING SHOE#___

 

LIGHT KITS

ÿ BHUL

ÿ LOWELL OMNI (LARGE)

ÿ CAMERA LIGHT #1 (XL-1, GL-1,)

ÿ CAMERA LIGHT #2 (SONY 370)

ÿ SANDBAG #___

 

TRIPODS

ÿ HEVY DUTY (SONY 370, SONY 325) #___ÿ REAR CONTROL ARMS#___

ÿ LIGHT DUTY (XL-1, GL-1, S-VHS) #___

 

MISC.

ÿ BNC VIDEO CABLE #___

ÿ BNC TO RF ADAPTOR #___

ÿ BNC TO RCA ADAPTOR #___

ÿ BNC TO BNC ADAPTOR #___

ÿ POWER STRIP #___

ÿ EXTENSION CORDS #___

ÿ DUCK TAPE

ÿ VIDEO TAPE DVCAM #___

ÿ VIDEO TAPE MIN DV #___

 

NOTES

        __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

 

 

 

 

 

 

OFFICE USE ONLY AT TIME OF CHECK IN AND CHECK OUT

 

 

CHECKED OUT BY_________________________ DATE_____________ Time__________

 

SIGNATURE OF BORROWER__________________________________ DATE__________

 

CHECKED IN     BY_________________________ DATE_____________ Time__________

 

SIGNATURE OF BORROWER__________________________________ DATE__________