Video Rental Form

[Smith faculty only]

Use this form to request rental of videos/films not held in the Five Colleges.
Request Five College DVDs & Videos using request Item in the Five College Library Catalog.
Book Smith and Five College DVDs & Videos for specific screening dates using the Video Booking Form.

Guidelines
Deadline:	Six weeks in advance.
Pick up and return:	Neilson Library Circulation Desk unless otherwise notified.
Search first:	Check the Five College Library Catalog for availability before placing requests.
Request Equipment:	Contact Media Services mediasvc@smith.edu or (413) 585-2954

Requestor Contact Information

Name: *

Email Address: *

Department:

Phone Number: *

Video & Film Information

(Click here for Five College booking)

For help identifying titles, dates and distributors, contact the Neilson Reference Desk in person, by phone (x2966) or by email at neilref@smith.edu.

1. Title: *

Publication Date:

Distributor:

Other Information:

Date of Screening/Use: *

(Month / Day / Year)

2. Title:

Publication Date:

Distributor:

Other Information:

Date of Screening/Use:

(Month / Day / Year)

3. Title:

Publication Date:

Distributor:

Other Information:

Date of Screening/Use:

(Month / Day / Year)

4. Title:

Publication Date:

Distributor:

Other Information:

Date of Screening/Use:

(Month / Day / Year)

5. Title:

Publication Date:

Distributor:

Other Information:

Date of Screening/Use:

(Month / Day / Year)

Special Instructions:

For more than 5 items: Please submit another form or email your list, with all of the requested information to videoreq@smith.edu,

Questions? Contact Jane Clayton: videoreq@smith.edu (413) 585-2914.

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Video Rental Form

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