Multimedia Duplication Request
Electronic Request Form
Use this form to request media duplication. If you have questions on duplication call ext. 2025.
REQUESTER INFORMATION
Name:
Phone:
Dept.:
Date:
E-mail address:
Media Type :
Video Tape
DVD-R
Audio Tape
Video to DVD transfer
*
Audio CD
DVD Creation
Data CD
Other, please specify:
* simple DVD, no menus, no chapter points
Quick check ship to:
Bloomingdale
Lombard
Naperville
Westmont
Addison
Library Circulation Desk
Bookstore
Media Sales
Who should we contact if we have questions about this order?
DESCRIBE YOUR REQUEST
Course/ Title number:
Lesson, Series, Tape Number:
Quantity Needed:
Master Number:
Personal Master, I will ship to Multimedia services.
How should the programs be arranged on the tape?
Single, one program per tape.
Double, two programs per tape.
Stacked, four programs per tape.
Rental, twelve programs per tape six hour mode.
How will this tape be used?
Instructional
In Class
Student check-out
Reserve
Promotional
Telecourse
Rental
Preview program
Other
Who should the media be shipped to?
Special instructions on shipping, labeling or packaging?
Please allow ten working days for multimedia duplication