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CD / DVD / Video Duplication Request Form

* Required fields are asterisked.

  User Information

* First Name
* Last Name
* Email address
Phone Number
Department  
* Month
* Day
* Year
* Title as it will appear on label

* Source Format:

  VHS
  CD-R
  DVD
  mini-DV

* Delivery Format:

  CD-R  # of copies
  DVD  # of copies
  QuickTime
  RealMedia

Special Instructions

  Before You Submit This Request

Please review all information you have submitted via this form to ensure its accuracy. Completed forms are entered into the system and processed in the order they are received. If you have any questions about completing this form, please call the HelpDesk at 542.6799.

 

* I have complied with all applicable copyright laws.



 

Sunday, Oct 12, 2008 :: 3:19:28 PM