Student Request for Audiovisual Materials

For Loyola undergraduate students, staff, alumni, and courtesy patrons.
Phone: (773) 508-2666, Fax: (773) 508-2993

Please allow 2-4 business days to process Loyola-owned materials.
Any orders placed after 4 p.m. on Friday will be available Wednesday of the following week.

Please complete this form for AV items that will be used for personal viewing or a class assignment.

Requests for materials and equipment for Class Presentations CAN NOT be submitted online.

Students who need AV materials for a class presentation should print out a copy of this request form.
Students must obtain their instructor's signature and Loyola Barcode ID# . Please fax the signed form to the AV Office at (773) 508-2993 or submit to a circulation desk.
If you need to request Audiovisual Equipment, please contact ITS Media Services at x44444.

Please complete both the "Patron" and "Audiovisual Materials" sections. Incomplete forms will not be processed and will be returned to the sender.

Items marked with * are required to process your request.

PATRON INFORMATION:
*Your Name:
10 digit Barcode# from ID:(required)*
Address:
*Home Phone:
Work Phone:
*Email Address:
Status:	Undergraduate
	Staff
	Alumni (Room Use Only)
	Courtesy (Room Use Only)
*Pickup Location:	Cudahy Library
	Lewis Library

AV MATERIALS INFORMATION:
Viewing Type:	Class Assignment
(Select one)	Class Presentation
	Personal Viewing
Number of Viewers:

*Title:
Call Number:
Materials Type:
*Date Needed(mm/dd/yyyy hh:mm):
Alternate Date(mm/dd/yyyy hh:mm):

* IF CLASS ASSIGNMENT:
Select one:
Course Title:
Instructor's Name:
*IF CLASS PRESENTATION:*
Class presentation request forms cannot be submitted online. Please see instructions at the beginning of this form.
Faculty Signature:
Faculty Barcode:

Additional Information about this request.

For further information, you may call the AV office at (773) 508-2666.

Student Request for Audiovisual Materials

PATRON INFORMATION:

AV MATERIALS INFORMATION:

Additional Information about this request.