Media and Reserve Library Video Order Form

This form is intended to provide a convenient method of requesting audiovisual materials. Each request results in an e-mail message which will then be processed as part of the general workflow. We may contact the requestor for additional information when necessary.

HELP-with this form

Name:

Status [indicate one]:

Faculty
Staff
TA
Graduate Student
Undergraduate Student

Phone:

E-mail address:

Department:

Office (Bldg and Room No.):

Course #:

THIS E-MAIL ORDER FORM CAN ACCEPT UP TO 4 TITLES AT A TIME

TITLE 1:
Pickup Date:
Return Date:
Catalog #:

TITLE 2:
Pickup Date:
Return Date:
Catalog #:

TITLE 3:
Pickup Date:
Return Date:
Catalog #:

TITLE 4:
Pickup Date:
Return Date:
Catalog #:

Confirmations for these titles will be sent to your office at the address indicated above.

All titles are to be picked up at the lower level, west wing service counter during the Media and Reserve Library's normal business hours.

If equipment is needed for the showing of the title, call I&MT's Equipment Distribution Office (Bolton 238) at x5527 to order.

NOTES:

SUBMIT your request.

CLEAR all fields (does not send a message).