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Media Resource Services
Media Request

Scheduling:
Materials are available on a FIRST COME, FIRST SERVED basis.
Loan Period:
Films are scheduled for one calendar day per individual. Videocassettes and laserdiscs may be checked out by faculty for seventy-two hours. Matherials borrowed for student use are the sole responsibility of the faculty member authorizing this form.
Delivery:
Materials may be delivered to the departmental office.
Personal Information: (** indicates a required field)
Instructor's Name: **
Department: **
Phone Number: **
E-Mail Address: **

Film / Video Information: (** indicates a required field)

Title: **
Catalog Number: **
Show Date: **
Alternate Show Date: **

Transit & Equipment:

Would you like to pickup the media item or have it delivered?
  Pickup in Media Resource Services
Delivery -- If so, enter location and date:
Building/Room:
Date Required:

Other Requests and Comments

We will contact you regarding availability of these other items.

Media Resource Services: Media Request Form / Albert S. Cook Library
http://cooklibrary.towson.edu/formMediaReq.cfm
Last revised: August 24, 2007

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