Job Reference No.
eLearning Academy (eLA)
REQUEST FOR SERVICES Types of Service Request: (Highlight or Shade ONE) Video Editing Video Recording Content Development Others (please specify):
Design
Develop Training Materials
Applicant’s Name: Staff ID No.: Division / School: Email: Contact: Budget Reference:
eLITe Grant
School / Division
Others:
Description of Job Request: (Give brief information pertaining to tasks as much as possible) Name of Function: Type of Function: Date Required: Time (Start):
Lectures
Meeting
Seminar / Forum
Others:
Date of Setup: Time (Ends):
Location / Venue: Function Liaison Person:
Contact No.:
Purpose of Function: (attach schedule where applicable) Other requirements, if any: I shall be present and undertake full responsibility for: The security and working condition of the items of audiovisual facilities installed in the above venue, and Making good any loss and meeting the cost of repair of the items of audiovisual facilities installed in the venue damaged, by whomsoever and by whatever cause, during the period of use. I acknowledge that Taylor’s University will not be held liable for any accidents arising from the use of the items of audiovisual facilities in the function venue. Applicant Signature:
Approved By:
Name:
Name:
Date:
Designation:
For eLA Use Only Approved By: Name:
Date: