Purchase Request  
We welcome suggestions for material to be added to the collections.  Budgetary considerations and Collection Policy are taken into account for each request.

* Are Required Fields!
1.   Media Information
Preferred: Preview or Purchase
Please indicate type of material:  Video Tape   Audio Cassette    CD-ROM
DVD            Teleconference     Other
*  Vendor/Distributor: 
If Vendor/Distributor is other please specify: 
Author/Director: 
If Author/Director was other please specify: 
*  Title: 
*  Date: 
Please verify the requested items has not been already purchased:  Select the campus to review current inventory
Item Cost
Item #
Source of information / Additional information: 
* Campus:
2.   Patron information
*  Name: 
*  Email:  @pbcc.edu
Telephone: 
Status: 
Supervisor:
* Supervisor's Email: @pbcc.edu