Transportation Safety Center – Licensing Section

Request For Video Approval Form

Name of School:

Address:

In submitting this form you are asking TSC-Licensing staff and TSD to review and evaluate the content and purpose of this video. If the form is not fully filled out or the information is not substantial it will be returned.

Name of Video and Date:

Publisher/Source:

Link to Video Source (if possible)

Length of Video: minutes	Combined time of all videos for course: minutes

Purpose of Video:

(Please make sure that you submit a copy of the video)

Please cite specifically how this video fulfills the requirements of the NMAC Regulations:

Please note that if this form is incomplete or lacks information it will to be denied.

TSD-LC Staff Only:

Evaluation

Are the statements in the video accurate? Are the sources reliable and timely?

Are there existing reviews of the video, and if so, what is the general consensus about the quality?

On a scale of 1 to 3 (with 3 being highest):

How culturally relevant would this video be for a New Mexico audience?	2

How current does the video appear to be stylistically?	2

Observed Pros/Accuracies/Benefits:

Observed Cons/Inaccuracies/Objections:

Approved	/	Not Approved	(Circle one)

Signature of Licensing Staff