Published: 05-17-2018

Last modified: August 23, 2018

1

Media Purchase Request Form for Departmental Use

This form is for use by Pensacola State College faculty only.

Use the form below to request purchase a DVD or other media item for the Library to purchase at a one-time cost. Items purchased for departmental use can be housed either in your department or in Course Reserves at the campus library of your choosing.

Please check the PSC Library Catalog before submitting your request to make sure the Library does not already own the item. (Note: The Library generally does not purchase duplicates of items in the collection.)

The Library Liaison for your subject area may follow up with you for clarification and additional information as needed.

Requestor Information

Nameyour full name
Phone
PSC ID NumberYour 8-digit PSC Student/Faculty number, located on your ID card.
PSC Affiliation
Please describe your affiliation
Primary Department or Program
Please describe your department, program, or subject area.
Do you wish to receive updates on the status of your request?

Item Information

Please provide as much information as possible to ensure that the Library can select the correct item.

Artist/Director
Titleyour full name
Series Title and Volume(s)Only if applicable to item being requested.
Publisher/Distributor
Subject
Publication Date/Editionyour full name
Material Formatpick one!
Please describe the item’s format.
For what campus libraries should this item be purchased?
Should this title be available to students for checkout?
Price
Other information
Date Neededyour full name
Please explain why this title is important to your teaching and/or research. *
Are there any other departments/programs or faculty members who would benefit from this title? *
Additional Comments/Special Instructions
0 /

By submitting this form, you acknowledge that your request will be submitted to the PSC Library Collection Development Committee for further consideration. The Committee meets monthly. Fulfillment of requests is dependent upon budget availability and adherence to the PSC Library Collection Development Policy.

If you have any further questions or would like to know the status of your request, please contact Michael Lane, Library Services Coordinator, at 850-484-1393 or by e-mail at wmlane@pensacolastate.edu.

Step 1: InitialRequestor

Type your Department Head’s e-mail address in the box below and click the “Submit to Department Head” button.

Step 2: Department Head*

After receiving the e-mailed form from the initial requestor, please forward to Michael Lane, Library Services Coordinator, at wmlane@pensacolastate.edu. The e-mail from your address constitutes your approval.

*Note: The Library will not initiate purchases for departmental use without the form e-mailed from the department head’s address.If you would like to assign designees authorized to submit on your behalf, please let us know in advance to avoid unnecessary delay.

Previous
Next
FormCraft - WordPress form builder