Video/DVD Request Order Form

FOR FACULTY AND STAFF ONLY

If you have any questions, please contact Steve Rouzer at ext. 2346 or via email at srouzer@stevenson.edu.

Please check the SHARC Catalog to see if the library already owns the title before proceeding with this request.

Required fields are noted in RED.

A downloadable copy of this form is available for individuals who prefer to fill in a paper form.

Date of Request:	07/31/2010
Requested By:
Department/Program:
Do you want to be notified when the item is received? Yes No
If you would like to be notified, how do you prefer to be notified?
Please enter your contact information in the box below:

Reason for Request

Please name the course or courses that this item will support and when they will be taught:

Will the title be put on reserve? Yes No

Suggested for Circulating Collection? Yes No