PHOTOCOPY & DISTRIBUTE THIS FORM

                  MAIL, FAX or SEND this BATCH ORDER FORM to:
                      Morris County Media Services Center
              161 Whippany Road    Whippany, New Jersey  07981-1700   
          (973) 884-0980    FAX (973) 560-1130    Email  mcmedia@nac.net
                 Attention: Diane Streckfuss, Booking Supervisor

                 
          You can request dates in advance FOR THE ENTIRE SCHOOL YEAR.
                      USE ONLY ONE TEACHER NAME per form.


     District Code (4 digits)__________ District Name____________________
     School Code   (3 digits)__________ School Name  ____________________
     Teacher Code  (6 digits)__________ Teacher Name ____________________


     PLEASE CHECK DESIRED OPTIONS: (You can request media for two weeks
     only if you need it. Otherwise, one week is standard. This lets 
     teachers in other schools use more items.)

               _____ 1. Send Next Week  
               _____ 2. Send Up To One Month Later  
               _____ 3. Send Next Available Date  
               _____ 4. Substitute Video Tape/Film
               _____ 5. Keep For Two Weeks

    Catalog No.                  Title                     Delivery Date 
                                                        (In Order By Date)

1. __________  _________________________________________  ________________

2. __________  _________________________________________  ________________
  
3. __________  _________________________________________  ________________
 
4. __________  _________________________________________  ________________

5. __________  _________________________________________  ________________

6. __________  _________________________________________  ________________

7. __________  _________________________________________  ________________

8. __________  _________________________________________  ________________

9. __________  _________________________________________  ________________

10.__________  _________________________________________  ________________

11.__________  _________________________________________  ________________

12.__________  _________________________________________  ________________

13.__________  _________________________________________  ________________

14.__________  _________________________________________  ________________

15.__________  _________________________________________  ________________
                                                         
       For more space, use other side, or attach another form.                                           
       Copy and distribute this form, or ask for more. (7/00)