COMMUNITY CLASSROOM DVD REQUEST FORM
Please complete all requested fields below. This information will help us better understand the community of educators we serve.
Allow 4-6 weeks for ITVS to process your order and send the requested materials. Note that at the present time, we can only fulfill requests inside the U.S. (including Puerto Rico, American Samoa, Guam, Virgin Islands).
Streaming video and classroom activities are available at PBS.org. Thank you for your interest in Community Classroom.
CONTACT INFORMATION
School/Organization
*First Name*Last Name
Title
*Address Line 1
Address Line 2
*City*ST*ZIP
PhoneFax
EmailWebsite
*Organization Type:
Nonprofit
NGO
School
Other
If a school, please specify type:
Charter
Public
Independent (not taxpayer funded)
Home-based
Other
If a school, please specify subject area:
Health and Fitness
Math
Media Literacy
Performing Arts
Reading and Language Arts
Science and Tech
Social Studies
Visual Arts
Other
COMMUNITY CLASSROOM MATERIALS
In an effort to reduce shipping costs, we ask that you request no more than three titles per order. If you would like to request additional titles, please submit another online request after receiving the shipment from this order.
*Requested Titles:
COPYRIGHT CRIMINALS
HIP-HOP: Beyond Beats & Rhymes
KNOCKING
SENTENCED HOME
VOTE DEMOCRACY
WOMENS EMPOWERMENT
Please indicate your educational setting, providing the class subject or course title you instruct, youth program, training field or other descriptive information.
*Educational Setting
College/university
High school
Middle school
Youth Organization
Professional Training
Other
Please provide a brief description of how you will use the COMMUNITY CLASSROOM materials:
*Please estimate how many students will be reached using these resource materials in the current school year:
Less than 50
50-100
100-150
150-200
Other
Once all of the information above is complete and correct, you must:
