Request a Film/Video
  • If you are requesting a film for viewing only by a class of Ivy Tech students enrolled in a course, and the film is connected to the learning objectives of the course, continue to the Suggest an Item for Purchase form.
  • If you are requesting a film for an audience that might include persons who are not Ivy Tech students or students who are not enrolled in a course using the film for course work, fill out and submit the form below.
  1. Instructor/Staff Name:
  2. Email address:
  3. Which campus would make use of this film?
    South Bend
    Elkhart
    Warsaw
  4. What is the title of the film?
  5. Who is the director or principle actor?
  6. Describe the intended use of this film.
  7. Will this film be shown ONLY to students enrolled in an Ivy Tech course?
  8. Will there be any charge or fee to view this film or for concessions?
  9. If this film will be shown to Ivy Tech students enrolled in a course, will the instructor be present?

  10. Form created by Form Forge. Contact  jfribley@ivytech.edu for assistance.