Michael Schwartz Library

DVD/Video/Film Request Form

Permanent Media Reserves
Michael Schwartz Library, Rhodes Tower
the Library and Research Help Desk, RT100
Phone: (216) 687-2479 ~ Fax (216) 687 – 5463

NOTE:

Please request CSU media reserve items 24 hours in advance.
This form is for Faculty/Staff use only to reserve media for classroom instruction.
Submit only one request per form

*Indicates required fields.

Requestor Information

Today's Date:

*CSU ID:

*Faculty/Staff Name:

*Department:

Campus Phone:

Other Phone#:

*E-mail Address for confirmation:

DVD/Video/Film Information

Owned By CSU?

Does Michael Schwartz Library own it?:

Yes No Not Sure

CSU Title:

CSU Call Number:

Rental Title:

Rental Source:

Rental ID #:

Rental Phone #:

Any Additional Information:

Viewing & Pick-Up Information

CSU Course No.

*No. of Showings:

*Est. Attendance

*Pickup Date :

*Pickup Time

*Pickup Location:

Loan Period is for 7 days. Please return materials promptly.

Rental fee to be paid by Michael Schwartz Library, Cleveland State University. Overdue fees are the responsibility of the borrower.

For equipment requests, call Valerie Isom at the Center for Instructional Technology & Distance Learning (CIT&DL) at 216-687-3846.

Motion Pictures and other Media are protected under Title 17 U.S. Copyright Code, Michael Schwartz Library Circulation Policies, vendor rental policies, and some leasing and licensing restrictions are applicable. No admission fees, paid public advertising or commercial telecast permitted.