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Media Library Reservation Request Form

Place your cursor in the first form box, then use the tab key for subsequent boxes.

Please include all of the information requested below. You will not receive a reply unless an e-mail address is provided.


Your Name
Your Campus Phone #
Your E-mail Address




Shelf Reserve

Inclusive Dates of Shelf Reserve

From To

Date video to be shown.*

Title of Media
Call No.
Course No.
* Reserved videos will be available for checkout three days prior to show date.
Additional Comments:


IMPORTANT: This is only a request. The item(s) may not be available for the dates of your request.

You will receive a reply within 48 hours or, if submitted on a Thursday or Friday, by the following Monday.

your request.