Applicant Name: (please print)	Campus ID:
Telephone:	Email:
Date & Time Requested:
Names & Campus IDs of others who will work on this project: (please attach)
Course Name:	Course Number:
Instructor Name:	Instructor Email:
Description of the project, including areas of the building you want to use and why:  (please attach additional information as needed)

Regulations governing use of the library for video/film production:

• Library users may not be distracted or disturbed by actors or crew
• Any equipment used in the project may not impede access to rooms, aisles, or furniture
• There can be no access to private offices or areas in which building tenants reside without written permission of the occupant
• Any activity must conform to normal building hours
• Food and drink (except water) may not be consumed during the project
• There can be no alteration of normal lighting in the areas of activity
• If it is necessary to move furniture, it must be returned promptly to its original position
• Damage and/or power interruption must be reported immediately to a library staff member
• All library restrictions regarding smoking, animals, bikes, etc. will remain in force
• The library does not endorse any point of view or position that may be espoused by the production, and credits should include this disclaimer

On behalf of the cast and crew I attest to the accuracy of the information provided above, agree to the regulations governing the use of the library for video/film production, and accept financial responsibility for any damage/loss incurred as a result of my project.

Signed ______________________________________________________________   Date __________________________

Completed forms should be brought to the supervisor in charge at the Circulation Desk on first floor.

Allow 7 days minimum prior to the project date for approval.

Approved _________    Denied _________    Comment ______________________________________________________________________