Please fill out the form and fax to Judi O'Neill at 816-268-8295

Video Loan Form

Today's Date:__________

Name:__________________________Title:__________________

School/Organization:_____________________________________

Address:_______________________________________________
(city, state, zip)

Phone______________________________

E-Mail____________________ Fax:________________________

Video Title:___________________________________ Video Value:______

Number of students viewing video:____ Grade level of students:______

Dates Requested:___________

Video must be returned to the Truman Presidential Museum & Library no later
than_______________

• Video sets are checked out as one title.
• Replacement cost for videos that are lost, stolen, or damaged will be paid by the person to whom the video was checked out.
• Cost of return shipping and mailing will be paid by the person requesting the video.
• A fee cannot be charged to view a video.
• Videos are to be used for educational purposes only.

I agree to the above terms.

_____________________________(name) ________________(date)