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Library Audiovisual Media/Equipment Request Form

Please use one form per course. The earlier a request is submitted the greater chance it can be delivered. If unable to contact media, please contact the circulation desk in the library for media requests.

MM slash DD slash YYYY
Days course meets(Required)

Equipment Required- Delivered

* If no equipment is required for delivery, please select “NONE”
Check all that apply

Equipment Required – Faculty Pickup/Return

* If no equipment is required for pick-up, please select “NONE”
Check all that apply

Instructional Materials Required

Note: Instructional Material is delivered to classroom