Chaplain Video Lending Library

P.O. box 621, Bradenton, FL 34206 USA 941-748-3031 fax 941-748-2625

Date: _________________

VIDEO LENDING SERVICE

GUIDELINES FOR VIDEO USAGE

1. The videos are to be put into return mail by the date on the packing slip (about 2 weeks.) The videos may be shown as many times as desired during the allotted time. All videos have been cleared for public performance, and may be shown ONLY within the boundaries of the jail/prison. Written documentation will be provided upon request The videos MAY NOT BE COPIED FOR ANY REASON. The response portion of the packing slip MUST be filled out for each video. THIS IS VERY IMPORTANT. One video may be requested at a time. Subsequent tapes in a series can be sent immediately upon receipt of each returned tape. Aurora Ministries will provide updated video lists as new tapes are added to the service.

2. Please check type of population at your facility. _____ M/F _____ M _____ F _____ Youth

VIDEO LENDING SERVICE AGREEMENT

I am interested in borrowing videos from Aurora Ministries. I agree to use the videos according to the guidelines listed above. I will do all I can to protect the tapes and return them on time. I understand that I will not be held responsible for loss or damage to the videos for situations beyond my control. I recognize that Aurora Ministries may not be in full agreement with the content of every video provided through this lending service. I will do my part to help the inmates and staff understand the message presented.


Chaplain:_____________________________________________

Facility Name:_________________________________________

Facility Street Address* __________________________________________________________

City _________________________________________________________

State _____ Zip _____________________

Phone Number Where You Be Reached ________________________________________

*Videos will not ship to a PO Box, so we need a physical address

Please return this form to:

Video Library
P.O. Box 621
Bradenton, FL 34206