• Submit your request at least 8 weeks before you plan to use the video/DVD.
• To discuss curriculum-related questions and final purchase decisions, contact Roxanne Dimyan, Faculty Video/DVD Liaison, at rdimyan@clark.edu or (360) 992-2427.
• For questions regarding your order, contact Sally Demos, at sdemos@clark.edu or (360) 992-2257.
• The library will attempt to purchase DVD formats unless requested otherwise.
• Return to: Sally Demos, Mail Stop # LIB 112

TITLE: ________________________________________________________________

PRODUCTION YEAR: _____________ ESTIMATED PRICE: __________________

SOURCE OF TITLE: ____________________________________________________

1. Have you previewed this title? _________

2. In what classes would this be used?

______________________________________________________________________

3. What other division of instruction might use this title?

______________________________________________________________________

4. Approximately how many times would YOU use this title in a year? _______

5. This video may be out of date within: (Please check one)

1 year ___ 5 years ___ 10 years ___ Never ___

6. Is other funding available to apply towards purchase? Yes __ No __

Please specify: _________________________ Budget Number: ____________________

Signature Authority for Budget Number: ________________________________________