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Kiosk Request (2013-2014)


2013-2014 Kiosk Reservation Form

Thank you for your interest in using the UC IPM kiosk. We will make every effort to accommodate your request and will contact you within 5 business days of receiving this form.

Please fill out a separate request form for each event or location, even if using the kiosk for back-to-back events. For example, if the kiosk will be displayed at 3 different libraries, fill out this form 3 times and provide all the dates and addresses for each library. If the kiosk will be used at a one-day event then at a retail store, fill out the form 2 times: one for the event and one for the store.

This form is for use by UCCE employees, UC Master Gardeners, and UC affiliates, not the general public.

Before requesting a kiosk, please read the kiosk facts and use information at

Kiosk Reservation Dates

Enter the ACTUAL DATES the kiosk will be on display for the public. Pick up and return dates will be arranged after your reservation is confirmed.

We will factor in extra days before and after your use for transport.

**Please submit a separate form for each event or placement.**

Location Details

Note: this information will be placed on our kiosk web page to advertise kiosk locations to the public.


Kiosk communication

You will receive an automatic email response once this form is submitted. We will contact you shortly to confirm your kiosk reservation.


If you are not a UC ANR employee, please list the name of who in your county has approved the kiosk use for this event (MG Program Rep, Advisor, County Director).

For verification that you are human, please enter the following code in the box below:

(if the code is not entered correctly, the survey will not be submitted)