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Media Resource Services
Rental Request

Rental Requests will only be honored
for the faculty of Towson University.

Please submit all film / video rental requests SIX WEEKS prior to showdate.

All rental requests are to be submitted through MEDIA RESOURCE SERVICES.
Any films / videos individually ordered will be the sole responsibility of the
person placing the order.

Personal Information: (** indicates a required field)
Instructor's Name: **
Department: **
Phone Number: **
E-Mail Address: **

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

Format: Film
 Laser Disk
 Video
 DVD

Title: **
Source / Vendor: **
Rental Fee: **
Show Date: **
Alternate Show Date: **

Would you like to pickup the rental or have it delivered?
    Pickup in Media Resource Services
    Delivery -- If so, enter location:

Other Requests and Comments

We will contact you regarding availability of these other items.

Media Resource Services: Rental Request Form / Albert S. Cook Library
http://cooklibrary.towson.edu/formRentalReq.cfm
Last revised: September 25, 2012