Video Request Form

Faculty may request videos to be used in their classrooms or they may put videos on reserve in the library for use by their students. If you have any questions about the process, please call extension 3055 for assistance.
*Please fill in the entire form before submitting*

Instructor Name:

Campus Phone Extension:

E-Mail Address:

Date Needed: -- mm/dd/yy 

Time Needed: -- am/pm

Return Date: -- mm/dd/yy   (MUST be filled in)


To which campus would you like this video delivered? 


Please list the title and call number of the video in the field below and submit your request.