ITV Streaming Media Request Form

DL Information

Please refer to Streaming Media Procedures before completing this form.

Faculty Information:
Instructor Name:	ACC Email Address:	Phone Number:
Course Information:
ITV Course Name: Ex: Personal Health	ITV Course Number: Ex: KINE 1304	Synonym: Ex: 54321
Semester: Ex: Fall 2009	Telecourse Video Series: Ex: Journey to Health
* Blackboard: I already use Blackboard for this course. I have already submitted a Blackboard Course Request Form for this course. I have not yet submitted a Blackboard Course Request Form for this course. *Due to licensing restrictions, ITV telecourse materials must be streamed via Blackboard.
or Note: After submitting the form, you will be redirected to the Distance Learning homepage.