Duplication Request

Please use this Media Duplication Request form for ordering events recorded by Concordia Media Productions for participants of the respective Concordia University Chicago event. * All fields are required.

Program Information

Program/Concert/Event TitleEvent DateFormatQuantitySelf-Provided Media





Customer/Delivery/Payment Information

Name:
Phone:
Email:
Delivery: I will pick this up
Deliver to on campus box
Deliver to my home (free shipping)
Campus Box#:
Payment Method: Cash
Check
CUC Account
 
Department:
Dept. Account #:
(1-xxxxx-xxxxx-xxx)
This order is a CUC Departmental Academic Requirement
Please make check payable to
'Concordia University' for .


All requests are subject to review and pre-approval. Concordia Media Productions reserves
the right to revise or cancel any submitted requests without notice.















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