Media Request Form

Media Reqest Form: Video Recording from TV or Satellite

Personal Information

Your Name:

Your Affiliation w/GCC

Faculty Student Staff Other

Phone:

Email Address:

Department or Student Organization / Club

Department Chair or Club Advisor

Details of Request

Campus: Main North

Taping Date:
Must use mm/dd/yyyy format (ex. 02/14/2008)

Channel: Satellite: Polarity:

Program or Event Title:

Series Title:

Tape From:
Must use am/pm (ex. 3:00 pm)

Tape To:
Must use am/pm (ex. 4:00 pm)

Any comments or additional information

A media technician will contact you regarding your request.

This form is to be completed to request the Library Media department to video record programs. The tape will be erased after 10 days. Please complete the information requested. If you have questions, contact the Media Department, 623.845.3119.


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John F. Prince Library - Glendale Community College - 6000 West Olive Avenue - Glendale, Arizona 85302 - 623.845.3109
Library & Computer Center - Glendale Community College North - 5727 W. Happy Valley Rd - Glendale, AZ 85310 - 623.845.4109
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Modified: Modified: April 18, 2009