Teleplex Services Request Form

OPTIONAL REGISTRATION/LOGIN

Registration is not required. Registration saves time for frequent users of our services, however, and provides access to information otherwise unavailable.

You may fill out the form, below, register or, (if you have already registered,) log in:

PRODUCTION SERVICES REQUEST FORM

Teleplex Production Services provides assistance to faculty, staff and authorized university organizations. Material is for on-campus use only. (i.e. media for classroom use; faculty research) Teleplex Production Services does not provide material for off-campus clients, or projects for personal use. The Copyright Clearance Office, located in Bracken Library, must clear all copyright material.

Any item with an asterisk(*) is required within a selected area.

REQUESTER
First Name *
Last Name *
Phone *
Email *
Budget Code *
Services and materials provided without charge for the project are to be used for instructional purposes in university classrooms. One copy of the project will be provided to the requestor and an archive copy will be placed in the library. Additional copies will be charged to the provided budget code.
BSU Department *

If you are charging this project to a department or grant not included in the menu, above, enter the department/grant name and code, below.
Other Deptartment *
Department Code Number *

The department and budget codes will be used for billing and tracking purposes, only.
VIDEO TAPING EVENT INFORMATON
Do you require video taping? *	Yes No
Event *
Event Location *
Event Summary *
Persons Featured
Project Use*	Instructional Purposes, Only Public Viewing
Event Date *	Month: Day: Year:
Event Time *	Hour: Minute: AM/PM:
Format for Your Materials * (Press the Ctrl or Command key to make multiple selections)
Due Date *	Month: Day: Year:
Copyright*	Copyright(s) Owned/Permission Acquired/Original Material Copyright Permission Needed, but Not Acquired Fair Use: No Copyright Permission Needed Uncertain: Copyright Consultation Required

VIDEO EDITING
Do you require video editing? *	Yes No
Project Use*	Instructional Purposes, Only Public Viewing
Persons Featured
From Format * (Press the Ctrl or Command key to make multiple selections)
To Format *
Due Date *	Month: Day: Year:

DUPLICATION
Do you require duplication? *	Yes No
Project Use*	Instructional Purposes, Only Public Viewing
Persons Featured
From Format
To Format * (Press the Ctrl or Command key to make multiple selections)
Due Date *	Month: Day: Year:
Copyright*	Copyright(s) Owned/Permission Acquired/Original Material Copyright Permission Needed, but Not Acquired Fair Use: No Copyright Permission Needed Uncertain: Copyright Consultation Required

COMMENTS/QUESTIONS

NOTE - Submitting this form does not automatically schedule your request. You will be contacted within 24 hours to confirm.