Stereo Theater Show Proposal Form Your Name:___________________________________________________ Address:_____________________________________________________ City/State/Zip Code:____________________________________________ Phone/Fax/E-Mail:_____________________________________________ Program Title:_________________________________________________ Description of Program:_________________________________________ _____________________________________________________________ _____________________________________________________________ Proposed length of your program:________________________________ Check all the equipment you will need: € Ektagraphics (2x2) How many?____ € Brackett Dissolve (41x101mm) € View-master (see below) € RBT projectors (41x101 RBT mounts) € 2 channel cassette tape € 4 channel cassette tape € Microphone for narration € Other:______________________________________________________ Note that if you have a View-master show, you need to specify the following: € I wish to show only at the View-master meeting. € I wish to show only in the Stereo Theater. € I wish to show both at the View-master meeting and in the Stereo Theater. For the Ektagraphics with Brackett Auto-Synch II dissolve, 1000 Hz pulse signal will be needed. If you need other dissolve equipment, you may need to supply it. For the RBT projectors, the Baessgen Triplex dissolve unit can handle the following signals: 1000 Hz pulse, Plustrac, Freetrac, Syncode, Kindermann, Leitz Du 24, Simda F 101, UD-2000, UX-2000, and Kodak P-Com. Please check the following: € I will be attending the convention. € I will not be attending the convention. € I will project my show. € I would like for someone to project my show. € I would like assistance to project my show. Comments: ___________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ Please send this completed form to: John and Dace Roll 5953 Shelford Lane Rockford, IL 61107-2573 or E-Mail the above information to johnroll@uic.edu Questions? Call us at (815) 654-8977 or E-Mail johnroll@uic.edu

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