Media Request Form

Media Request Form - LMC @ GCC

Media Reqest Form: Duplication and Conversion Services

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

Project Deadline:
Must use mm/dd/yyyy format (ex. 02/14/2008)

Program or Event Title:

Choose Media:
Video        Audio        Photo        Computer

Original Format:
Duplicate to:

Number of Copies:

Any comments or additional information

A media technician will contact you regarding your request.

This form is to be completed for duplicating video tapes, audio tapes, photographs, computer. Please complete the information requested. If you have questions, contact the Media Department, 623.845.3119.

Employees are prohibited from copying materials not specifically allowed by the 1) copyright laws, 2) fair use guidelines, 3) licenses or contractual agreements, or 4) other permission.


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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