Catholic Diocese of Columbus

Department of Religious Education

AV MEDIA REQUEST FORM

Voice 614-221-4633

FAX 614-241-2563
1-800-688-4641

avmedia@cdeducation.org

Name of Contact Person: Telephone #:
E-mail Address: FAX #:
Name of Parish or School: City:

(Use as many lines as necessary.)

Name of Video Catalog # Date Needed
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10.

If videos will be picked-up:
Date of pick-up:
Date of return:
Name of pick-up contact:
If videos will be shipped USPS:
Must have by:
Date of return:
Name of recipient: