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Media Production Request Form
Please fill out and submit this form for all video and audio request's.
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1
Requesters Name
*
This field is required.
First Name
Last Name
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2
E-mail
*
This field is required.
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3
Phone Number
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4
Cell Phone
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5
Do You Work For Middlesex County College?
*
This field is required.
YES
NO
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6
What Department?
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7
What Organization or Company Are You From?
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8
Name of Production
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9
Live Recording or Media Production
Please select Live Recording if you are looking to capture a Live Event or Class that is scheduled at a specific date and time. Select Pre Recorded if you are looking to create a pre scripted Promotional or Instructional audio or video recording.
Live Recording
Pre Recorded
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10
Type of Production
Video
Audio
Photo
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11
Location of Live Event
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12
Date and Time of Live Event
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Date
Month
Day
Year
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Hour
00
15
30
45
00
00
15
30
45
Minutes
AM
PM
AM
AM
PM
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13
Desired Date and Time to Record
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Date
Year
Month
Day
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Hour
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15
30
45
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15
30
45
Minutes
AM
PM
AM
AM
PM
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14
Need Production Completed By
-
Date
Month
Day
Year
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15
Type of Live Event
Interviews
Lecture
Public Address
Workshop
Awards Ceromony
Other
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16
Type of Video Production
Interviews
Instructional
Promotional
PSA
Other
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17
Type of Audio Production
Radio Spot
Voiceover
Live
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18
Production Extras
B- roll
Lower 3rd's
Green Screen
Backgrounds - Solid
Backgrounds - Motion
Backgrounds - B-roll
Backgrounds - Virtual Set
Motion Graphics
Music
Slides
Voice Over
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19
Length of Production
30 sec
1 min
2 min
3 min
4 min
5 min
6 min
7 min
8 min
9 min
10 min
15 min
20 min
30 min
60 min
90 min +
30 sec
1 min
2 min
3 min
4 min
5 min
6 min
7 min
8 min
9 min
10 min
15 min
20 min
30 min
60 min
90 min +
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20
Is This Production Part of a Series?
YES
NO
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21
Series Name
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22
Video Delivery Format
Digital Copy
YouTube
Live Stream - YouTube
Live Stream - Facebook
Other Format
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23
Do you have permission to use materials that will appear in the video? Materials may include a written script, photographs, video clips, music, etc
*
This field is required.
YES
NO
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24
Do you have permission to record the people who will be featured in your video? Video participants (eg event speakers, interviewees etc) must provide their consent to be filmed and fill out A Middlesex County College consent and release form.
*
This field is required.
YES
NO
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25
Consent Form
*
This field is required.
Click consent form below to download a copy of the form.
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26
Script (Upload)
Drag and drop files here
Select files to upload
Max. file size
: 10.6MB
Browse Files
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27
Additional Information
Please provide us with additional information about this recording.
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