Form for Requesting Bibliographic Records (VIDEOs & DVDs)

**Fields in bold are required**

You may also print this form and fax or mail if you prefer

Your Name:

Library Name:

Email:

ISBN (use "x" if no ISBN):

Video publisher number:

Title:

Director/Producer/Performer (list only 1 or 2 primary names):

Date:

Publisher Name:

Running time:

Number of videocassettes or discs. YOU MUST SPECIFY WHETHER YOU HAVE VIDEOCASSETTES OR DVDS!!!:

Notes (for any additional information you wish to provide such as performer name, series statement, accompanying materials, language other than English, etc.):