Dvd Purchase Request Form printable pdf download

Dvd Purchase Request Form

DVD PURCHASE REQUEST FORM

Department _______________________

Name_____________________________

Phone

1. Complete Title of Video or DVD (one title per form)

Dept’s Priority for title

(Ex. 1 of 3, 1 of 5)

3. Circle to indicate format preference

VIDEO

DVD

4. Price $

5. Source (producer or distributor and address) Please attach a copy of the order page and catalog page

6. Has this title been viewed?

YES

Faculty reviewer(s):

7. Faculty Involvement

(List faculty who will use the video)

8. General Instructional Need(s) To Be Met

Describe the instructional situation to be improved by the video purchase--include frequency of use and courses,

selections and numbers of students who would benefit from the video. Estimated numbers are acceptable.

Course

# of sections

Enrollment

Total Students

Total

Numbers

Fall/Spring/Summer

Ave./Sect.

Year/Course

Served

For Library Use

Reviewed

Received

Approved

AV Number

Reasons Not Approved:

High cost of video/Not previewed

Other Items Higher priority of department and funds expended

Requires purchase of additional or specialized equipment for use/storage

Is not consistent with established policies for collection development

Would be more appropriately purchased using departmental, grant or other funding sources

Library currently has videos in this subject area not being used

Dvd Purchase Request Form