Humanities Tennessee

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Video Request Form

Instructions

To request a video from our library, please fill out the form below. If you want to begin again, use the "clear" button at the bottom of the page; when you have completed the form, use the "submit" button at the bottom of the page.

NOTE: You may request multiple videos, but you must submit this form separately for each title. For more information, please consult the Video Library Guidelines and Instructions.

Organization name (required):
Organization address (required):
Organization phone (required):
Program Coordinator name (required):
Program Coordinator address, if different from above:
Program Coordinator phone, if different from above:
Program Coordinator email (required):
Video title requested (required):
VHS
DVD

Preferred presentation date(s) (required):
Alternative presentation date(s):
Number of presentations planned:
Brief narrative of proposed use of film(s), including projected audience size and venue (required):

In accepting a Program Bureau video, the sponsoring organization agrees to comply with the following regulations:

To charge no fee for the public to attend the program
To publicize the program widely among the general public, and acknowledge Humanities Tennessee for its role in the program
To complete and return the evaluation form, along with the video, to Humanities Tennessee, postmarked no later than three business days after the screening date
To be responsible for the cost of return shipping
To cover the cost of duplication if the video is lost, damaged, or destroyed.
To preview the video before deciding whether or not to show it to persons under the age of eighteen years. Humanities Tennessee makes no representation that the videos are appropriate for viewing by persons under the age of eighteen years.
To indemnify Humanities Tennessee from any and all liability for damages to any person for any claim arising out of the showing or viewing of the video.

By submitting below, you agree to comply with the regulations described above. You also certify that the sponsoring organization is a not-for-profit and that you are an authorized representative of that organization.

If you do not receive confirmation of your video request, please contact our program staff directly at paul@humanitiestennessee.org, or by phone at 615-770-0006, ext. 17.

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