Media Acquisition Form

Please complete the following form to obtain media titles not currently in the college's media library holdings. When complete, click SUBMIT at the bottom of the form.

Need help filling out this form? Watch the Media Acquisition Form Training Video.

Personal Information

* Your Network Username
 * Department Chair Username

* Billing Information: (Please check all that apply)

           Allocation from Audio Visual budget

           Allocation from Library book budget

           Account Number: .605

Special billing instructions


Distributor Information

Distributor Name

Distributor Address 1
 Distributor Address 2

City
 State
 Zip Code

Phone
 Fax


Media Information (Click on section headings to add up to four title orders.)

Title 1

* Date needed for showing

* Transaction Type

* Title
 Catalog Number
 Helpful description and/or weblink

* Format
 If Other

Price

Title 2

* Date needed for showing

* Transaction Type

* Title
 Catalog Number
 Helpful description and/or weblink

* Format
 If Other

Price

Title 3

* Date needed for showing

* Transaction Type

* Title
 Catalog Number
 Helpful description and/or weblink

* Format
 If Other

Price

Title 4

* Date needed for showing

* Transaction Type

* Title
 Catalog Number
 Helpful description and/or weblink

* Format
 If Other

Price


* - Required