Classroom Performance Request for DVD/VHS/Film
Title
Year
Distributor
Director
Format
DVD
VHS
35mm film
16mm film
Source
(e.g. Rented; purchased--either personal or departmental copy; borrowed from library; etc.)
Complete Viewing
Excerpt | Approx. Length
Instructor's Name
Department
Phone
Course ( e.g. HIST1000)
E-mail
Date of Use
No. of Students
Do you anticipate using this film more than once or more than one semester?
YES
NO
If yes, how often?
Any additional information available about the distributor/film (for unlicensed films only; e.g. distributor address, country of origin, etc.)
Click to submit information
Document Control Number: DELT 05-196 - Version 1 March 2008
