UNIVERSITY OF PITTSBURGH FORM INSTRUCTION GUIDE

FORM TITLE:  INSTRUCTIONAL MEDIA SERVICES REQUISITION
NUMBER:      FORM 0003 PITT 1866
PROCEDURE:   10-03-02
DATE:        September 7, 2005 Revised


INSERT THE FOLLOWING INFORMATION WHERE INDICATED:

1.   Name of patron.

2.   Pitt ID Card Number.

3.   Telephone number.  Include area code if necessary.

4.   E-mail address.

5.   Campus Address (Office room number and building.)

6.   Name of department initiating the service request.

7.   Course number.

8.   For charge orders, enter department account number including the
     subcode.

Service Required

9.   Check when equipment or an operator is required for a classroom.
     -    Date required.
     -    Start time (Indicate whether A.M. or P.M.)
     -    End time (Indicate whether A.M. or P.M.)
     -    Building name/abbreviation.
     -    Classroom number.

10.  Check when equipment is to be delivered to the patron's office.
     -    Date of delivery.
     -    Date of pickup.
     -    Building name/abbreviation.
     -    Classroom number.

11.  Check when equipment is to be picked up and returned by the
     patron.
     -    Date of pickup.
     -    Date of return.

Equipment Requested

12.  Place checkmark next to equipment required.

13.  Note any unlisted equipment or special requirements under
     "Other."

14.  Indicate whether a video tape is to be provided by patron or
     Instructional Media Services for video recordings.

Film/Video Requested

15.  Enter catalog number if known.

16.  List title.

17.  Date of class.  (MM/DD/YYYY) - Reverse side of requisition form
     may be used for additional space.

Other Services Available:

-    Instructional Technology Consultation

-    Media Enhanced Classroom training

-    Satellite downlinking

-    Teleconferencing

-    Video tape duplication and format conversion

-    ITV Classes