Media Desk Reserves Request Form

The following form is for the use of faculty and instructors wishing to submit requests for media material to be put on Reserve. This form is for media requests only (for BOOK REQUESTS, please click here) If the library does not currently own a requested title, we may be able to purchase it. Course material may also be submitted in-person at the Media Desk in the Digital Scholarship Commons.

Instructor Information

Instructor Name *

Phone Number

Email Address *

Campus Mailing Address *

Course Department and Number *

Example: HIST 190

Course Title *

Quarter and Year *

Example: Winter 2016

Item Information #1

Call Number

Title

Item Information #2

Call Number

Title

Item Information #3

Call Number

Title

Item Information #4

Call Number

Title

Add Item #5

Call Number

Title

Add Item #6

Call Number

Title

Add Item #7

Call Number

Title

Add Item #8

Call Number

Title

Add Item #9

Call Number

Title

Add Item #10

Call Number

Title

To request additional media items, please submit the first 10 through this form then resubmit this form with the remaining items.

Alternatively, you may submit your request in-person at the main circulation desk in either library.

Comments/Special Instructions

Leave this field blank

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Media Desk Reserves Request Form

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Media Desk Reserves Request Form

University
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