Video Production Request Form

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Please complete this form and submit. Your request will be reviewed, and you will be contacted by a producer soon.

I would like assistance with (check one):
Videotaping/Recording an Event (school play, concert, etc.)
Editing A Video Production
Video Encoding  QuickTime RealMedia WindowsMedia
Full Production (includes writing, producing, directing, taping and editing)

Full Name: 
Department/School: 
Phone: 
E-mail: 

Tentative Title of Program: 
Intended Program Length: 
Date Final Product Needed: 
Project Location: 

Briefly describe the project:

What is the purpose or goal of the project?:

Who is the intended audience?:

How will the final product be used?
Individually  By Staff  In a Classroom  Broadcast over Cable*

*If you intend to use copyrighted material, you must obtain written permission from the copyright owner.