Media Purchase Request Form
Fields marked with
*
are required.
Please Note:
Only faculty requests will be accepted.
Please submit your request as early as possible.
A request is not confirmed until library staff notifies the requestor by phone or email.
Requestor Information
Professor's Name
*
First Name
Last Name
Department
Phone Number (Office/Home)
Please enter a valid phone number.
Email Address
*
first.last@scranton.edu
Media Information
Please fill in separate media information for each item. Leave fields blank if unknown.
Media Purchase Request(s)
*
Additional Information
Please verify that you are human
*
Submit
Should be Empty: