INTERLIBRARY LOAN REQUEST

INTERLIBRARY LOAN REQUEST
NAME & PATRON NUMBER OF PERSON MAKING REQUEST*
EMAIL ADDRESS
example@example.com
PHONE NUMBERS(1st)*
Format: (000) 000-0000.
(2nd)
ITEM TYPE (BOOK, LARGE TYPE BOOK, DVD, AUDIOBOOK, ETC.)
TITLE*
AUTHOR
By filling out the signature portion of this form, it indicates I agree to return item by the due date. Failure to do so may jeopardize my Interlibrary Loan privileges. If a renewal is needed, please contact the library TWO OR THREE DAYS BEFORE the due date. In some cases, items are NON-RENEWABLE.
DATE

MonthDayYear
Date
SIGNATURE
YN
Book club date

MonthDayYear
Date
Should be Empty: