Untitled Document

Requesting a Media Purchase:
Instructions and Form

Please provide as much information as possible. Distributor information is important for educational films - it can be difficult to locate films without a source. An asterisk * indicates a required field.

*Instructor Name (First & Last): Faculty Assistant Instructor

*Dept: *Phone Number:

*Title of the item:

Format: VHS DVD CD-Rom Audiotape Audio CD

Year it was released or re-released

Distributor: Price:

Source of the item (Review, catalog, television, etc.):

If requesting a film, please give as much of the following information as possible:

Documentary Feature Film

Director:

Key Cast Members:

*Description:
(for detailed information on feature films and television movies, check http://www.imdb.com for help)

Are you requesting this title for class use? Yes No

Date you need this item by:

Any other information/instructions:

Requesting a Media Purchase: Instructions and Form

Requesting a Media Purchase:
Instructions and Form