This form is for American University faculty members to use to authorize students to check out videos for class presentations.

This is not a dynamic form and can not be sent to the library electronically because it requires a written faculty signature.

It must be printed and signed by the faculty member and the student then presents it at the Media Services desk to check out items.

For more information, see Faculty Services.

Directions:

1. Fill in all fields under both student information and faculty information
2. Print out the form by choosing "Print" from your browser
3. Sign the form where it says "Faculty Signature"
4. The student must present this form when he/she borrows the item for his/her presentation

Student Information

This authorization is for the use of a Media Services item(s) in a classroom presentation. The item(s) must be checked out within one hour before class and returned within one hour after class.

Faculty Information

I authorize this student to use my library account to borrow Media Services materials for an in-class presentation. This authorization is for one time only. I understand I am financially responsible for all materials charged out on my account, including fines accrued and replacement costs, if the item(s) is lost or damaged.

The above student is authorized to use my library account to check out Media Services materials on the following

date:

Faculty Signature: