Physics Lecture-Demonstration Facility
Demonstration Sign-Up Form

(Please complete the following form and hit VERIFY ORDER to verify and submit your order.)

Professor Name Password Class Number Room Number

Delivery Date (ie. MMDD)
Delivery Time


Demonstations (Enter a four digit demonstration number in textboxes to the left,
                  i.e A1-01)
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Other Equipment/Demonstration Requests (Please enter one item per line.)