Reserve Request Form

Instructor    Date

Department & Course Name

Date to be Removed  Course Number
   I will pick up my materials at the end of the semester
   Return my materials through inter-campus mail at the end of the semester
   Discard my materials at the end of the semester
Loan Period Choices:
   Two hour (Library use only)
   One day and Overnight (brought back anytime the next day)
   Three day
   One week

Author
Title   
Call Number    e-reserve Yes No

Author
Title   
Call Number    e-reserve Yes No

Author
Title   
Call Number    e-reserve Yes No

Author
Title   
Call Number    e-reserve Yes No

Author
Title   
Call Number    e-reserve Yes No

Author
Title   
Call Number    e-reserve Yes No

Warning Concerning Copyright Restrictions

The copyright law of the United States (Title 17, United States Code) governs the making of photocopies or other reproductions of copyrighted material.  Under certain conditions specified in the law, libraries and archives are authorized  to furnish a photocopy or other reproduction.  One of these specified conditions is that the photocopy or reproduction is not to be "used for any purpose other than private study, scholarship, or research."  If a user makes a request for, or later uses, a photocopy or reproduction for purposes in excess of "fair use", that user may be liable for copyright infringement.  This institution reserves the right to refuse to accept a copying order if, in its judgment, fulfillment of the order would involve violation of copyright law.

Signature of Instructor_____________________________________________