CD-ROM Request Form

UCI CD-ROM Request Form

COMPUTER-SUPPORTED CD-ROM/LASERDISK/DVD REQUEST FORM

Use this form for computer-supported cd-rom/laserdisk/DVD requests and trials.

Use liborder or the regular white request form for ordering videotapes and DVDs that are non-computer related (e.g. feature films, documentaries).

INSTRUCTIONS: Bibliographer go to Collections website and print out this form.

Sections I-V: Bibliographer fills out form as appropriate.
Section VI: LT approves for Technology Center testing.
Section VII: Technology Center tests product.
Section VIII: LT approves purchase.

Form revised November 14, 2009

I. BASIC INFORMATION

Contact E-mail Address (REQUIRED):

Date:

Bibliographer:

Fundcode:

Title:

ISSN (optional):

Vendor name:

Requesting faculty (optional):

Type of request: Trial Acquire

II. FORMAT

Medium (please check ALL that apply): CD-ROM Laserdisk Computer DVD
Other format, specify:

Type: Stand-alone Networked

Type of product (please check ALL that apply): Abstracts/index Database with search option Document Directory Program/Interactive media

Special format characteristics (please check ALL that apply): Sound Video Cartographic
Other, specify (e.g. Excel):

Platform (please check ALL that apply): Windows NT Windows 3.1 or higher Mac Both PC and Mac
Other, specify (e.g. DOS):

Restrictions on access (please check ALL that apply): Unrestricted access in library UCI users only (need library card) Via CD-Rom tower Password needed Circulates to users

Specifications (submit printed specifications, flyers or URL):

III. LOCATION

Location: ML / MRC SL / ILC MCL / ITC MLRI / GID SL Ref
Comments (Please explain multiple locations in Comments box ):

IV. PRICING

Paid by: UCI UCI & others (Tier 2) Potential change to web; provide any details re time-frame, cost impact, etc.

Type of fee: One-time price Annual subscription

Cost/comments:

For fee (paid):
for single workstation
for simultaneous users/networked stations (indicate number of simultaneous users desired in comments box above)
separate fees for mixed format (describe in comments box above)

V. LICENSING/RESTRICTIONS

License terms(preferably submit printed license agreement or URL):

Bibliographer's last step:
If the product has a license, send form and attached printouts to L. Tanji.

VI. COLLECTION DEVELOPMENT REVIEW

LT approval to test in Technology Centers Yes No
Signature:
Date:

VII. TECHNOLOGY CENTERS CONTACTS

Technology Centers:
Yes. We have equipment and technical support for this product.
No. We do not have equipment.
No. We cannot provide technical support

Technology Center Contact:
Signature:
Date:

VIII. COLLECTION DEVELOPMENT DECISION

LT Approval Yes No
Signature:
Date:

Use fundcode as requested by bibliographer. If not, use this fundcode:

END OF FORM

I. BASIC INFORMATION
Contact E-mail Address *(REQUIRED)*:
Date:
Bibliographer:
Fundcode:
Title:
ISSN (optional):
Vendor name:
Requesting faculty (optional):
Type of request: Trial Acquire

II. FORMAT
Medium (please check ALL that apply): CD-ROM Laserdisk Computer DVD Other format, specify:
Type: Stand-alone Networked
Type of product (please check ALL that apply): Abstracts/index Database with search option Document Directory Program/Interactive media
Special format characteristics (please check ALL that apply): Sound Video Cartographic Other, specify (e.g. Excel):
Platform (please check ALL that apply): Windows NT Windows 3.1 or higher Mac Both PC and Mac Other, specify (e.g. DOS):
Restrictions on access (please check ALL that apply): Unrestricted access in library UCI users only (need library card) Via CD-Rom tower Password needed Circulates to users
Specifications (submit printed specifications, flyers or URL):
III. LOCATION
Location: ML / MRC SL / ILC MCL / ITC MLRI / GID SL Ref Comments (Please explain multiple locations in Comments box ):
IV. PRICING
Paid by: UCI UCI & others (Tier 2) Potential change to web; provide any details re time-frame, cost impact, etc.
Type of fee: One-time price Annual subscription
Cost/comments:
For fee (paid): for single workstation for simultaneous users/networked stations (indicate number of simultaneous users desired in comments box above) separate fees for mixed format (describe in comments box above)
V. LICENSING/RESTRICTIONS
License terms(preferably submit printed license agreement or URL):
Bibliographer's last step: If the product has a license, send form and attached printouts to L. Tanji.
VI. COLLECTION DEVELOPMENT REVIEW
LT approval to test in Technology Centers Yes No Signature: Date:
VII. TECHNOLOGY CENTERS CONTACTS
Technology Centers: Yes. We have equipment and technical support for this product. No. We do not have equipment. No. We cannot provide technical support
Technology Center Contact: Signature: Date:
VIII. COLLECTION DEVELOPMENT DECISION
LT Approval Yes No Signature: Date:
Use fundcode as requested by bibliographer. If not, use this fundcode:
END OF FORM