Form for Placing Audio Visual Materials on Reserve

Audio Visual Reserve Form
Professor's Name*

First NameLast Name
Email*
You must use a Wittenberg University email address.
Phone Number

Area CodePhone Number
Course Name*
Course Number*
Date material needed by students:
Reserve Length*

2 Hours No Overnight2 Hours With Overnight1 day3 day7 day
Keep on reserve until*

End of fall semesterEnd of spring semesterOther
If "Other" please indicate when item should be taken off reserve.
Wittenberg Owned CDs
Artist Title Call #
Artist Title Call #
Artist Title Call #
Artist Title Call #
Artist Title Call #
Artist Title Call #
CDs You Personally Own
Understanding that library staff will use reasonable care while the following items are on reserve, I do not hold the library responsible for damage or loss.*

I agree
Artist Title
Artist Title
Artist Title
Artist Title
Artist Title
Artist Title
DVDs or VHS Owned by Wittenberg
Title Call #
Title Call #
Title Call #
Title Call #
Title Call #
Title Call #
DVDs or VHS Belonging to You
Understanding that library staff will use reasonable care while the following items are on reserve, I do not hold the library responsible for damage or loss.*

I agree
Title
Title
Title
Title
Title
Title
Materials to purchase and put on reserve
If there are audio visual materials that you would like Thomas Library to purchase for the library's collection, and put on reserve, please list them here and someone will contact you.
Signature*

Clear
Please verify that you are human*
Should be Empty:

Audio Visual Reserve Form