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Click for Library HomeVideo/DVD/Film Request (for purchase, preview, or loan)
This form is for use by Cuesta College faculty and staff only.

Please Note:

  • If the vendor requires a rental fee, preview fee, or purchase order for preview, a general requistion will be required before your order is processed. Please submit this form and you will be contacted by Peggy Lipe (x2690) as to the amount required.

  • If the video requires more than $100 in library funds, it must be be previewed.

  • All new DVDs and videos for classroom use must be closed-captioned per ADA requirements. If the item is not available with closed-captioning, your division must agree to facilitate or pay for its captioning. In this case, a District Purchasing Agreement for Non-Captioned Videos form is also required for your order to be placed. Contact Kelly Whitten in Academic Support DSPS (x2825) for more information on ADA requirements. Peggy Lipe can check if the video is available with closed-captioning and provide the form if needed (x2690).

Fields with an * are required fields and must be filled out for your request to be processed.


Name: * Division: *
Course: *

Campus Ext. * Home Phone
E-mail *

Select Type:* DVD VHS Videotape 16 mm Film

Title Wanted: *
Catalog No: *
Source: * (include phone, fax, e-mail or URL for ordering)

If previewing:

Preferred Date - From:*
To:*

Alternate Date - From:*
To:*
(Must be one week or more away.)

Select one:* Classroom Use Office Use Preview for purchase (no fee)


This form is for use by Cuesta College faculty and staff only.
For help or additional information, contact Peggy Lipe (x2690).

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