FLAME Video Lending Library

Please request all films by name and number. You, as a FLAME member, may rent 2 films per request but both must be returned at the end of 2 weeks. You will be notified if your video is NOT available. ( incl. email address)

The catalog will continue to be updated with descriptions etc. with YOUR help.

Please take the time to fill out the evaluation and return it with video(s).

We will all benefit from your input ! Thank you in advance!

Ruth Parent has graciously accepted to be in charge of the video lending library. To order videos, contact her at:

Dr. Lewis S. Libby School, 13 School Street, Milford, Maine 04461

Her email address is: Ruth_Parent@umit.maine.edu

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Dates requesting for____________________ When is too late? ________

Film request     1._____________________#_____ Incl. Worksheets___

               2._____________________#_____ Incl. Worksheets___

Phone #(W)__________(H)___________Fax#____________________

Your name:__________________________Email:_________________

*Include $2.60 for worksheets (packet) and / or .25 for 1 page worksheet if applicable. (Please make your check payable to FLAME)

Please return all videos promptly so that ALL may enjoy this service!(2 weeks from date received)

Mail to: ____________________________________

(name)

____________________________________

(school)

____________________________________

(address)

_____________________________________

(city, state) (zip)

RETURN THIS with video(s) &  payment (if you order worksheets): $________

VIDEO EVALUATION(S)

Please include TITLE and as much information as possible that is NOT already in the catalog and return this with your videos. Your help is appreciated and will improve future catalogs!

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Date(m/d/yr):___/___/___

Your name:___________________School_______________________

Phone number (W)___________(H)_________Email:__________

Title & # of video______________________ Length _______ Language____

Subtitles? Yes/No Date of film __________ Color or B&W

(A-F) Visual Quality _____ Audio Quality _____ Lang. Clarity _____

Overall "grade" _____

Comments:

Suitable for what type of audience? (circle all that apply)

Elementary, Middle School, High School Beginner, Intermediate, Advanced, Mature audience, ALL AUDIENCES

Other : (circle all that apply) Obscenities, Nudity, Challenges family values, intimate scenes, Violence.

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Title & # of video______________________ Length _______ Language___ Subtitles? Yes/No Date of film __________ Color or B&W

(A-F) Visual Quality _____ Audio Quality _____ Lang. Clarity _____

Suggestions for videos to buy in the future: (include company names and phone number if possible). Continue on back if necessary.

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