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Project

Today's Date:

This is Request for Select One Photography Production Video Production Both Video & Photography Production

Desired Completion Date:

Requestor's First Name:

Requestor's Last Name:

College or Administrative Unit:

School or Department:

Phone:

E-mail address:

Name of Project Lead: (if different from Requestor)

Project Lead Phone

Project Lead E-mail address

Brief Description of requested services, event, or project:

Date & Time of shoot (if required):

Location of shoot (if required)

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Project Background

Check all that apply.

This Is	An Instructional Support Project
	A General Fund Activity
	A Foundation Fund Activity
	For a Special Session/Open University Course
	For a Research Project
	For a Professional Presentation (ie: Conference, Special Event, or Poster Session)
	For a Professional Publication (ie: Textbook)

If source content will be edited, dubbed, or copied, what format is the original:
(check all that apply)

Video
DVD CD Video Tape Other

Photography
Film Negatives Film Slides Flat Art Work Books
Digital Still Images Other

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Project Deliverables

Finished product should be delivered in what form? (check all that apply)

Video
DVD CD Podcast Web Streaming Audio Tape Audio File

Photography
Photographic Prints Poster Session Print
Digital Files via Web Digital Files on CD or DVD

Please Note: An estimated turn around time will be provided when a MP&D Representative contacts you about this request.Scope of Project and other previously scheduled Projects will impact turn-around time estimate. Because our resources arelimited, we cannot accommodate every request and RUSH work is generally notavailable.Completion of this form does not guarantee acceptance of a request.Source materials must be left with Media Production until completion of project .

Click to Send to Media Production