Video Digitization Request

Please provide the following information:


Name :
Phone Number :
Email :
Institution :
Course Name and Number :
Title of Video to be Digitized:
Call Number of Video (if library owned):
Date Needed:
Part of Video to be Digitized (if clips please indicate times in the box below):

If you are requesting digitization of clips from a video please indicate the start and end times for each clip here: