Streaming Media Form

Dept./School *

Department Name *

Name *

Preferred Contact Info *

Requesting for self or other *

Name Other *

Title of Film *

URL for Film if available

Check out IMDB to find a URL for your film!

Year Released *

Director and/or Studio *

Amount of Film needed *

Start Date for Student Access *

Month

Day

Year

End Date for Student Access *

Month

Day

Year

Course Number *

Purpose/Audience *

Education Use (classroom setting online or physical) - optional assignment

Education Use (classroom setting online or physical) - tied to graded assignment

Public Performance

Required/Optional Viewing *

Required

Optional

Additional info

Libraries