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Interlibrary Loan                               Periodical Request#

Please fill out the following form as completely as possible and click Submit: Confirmation will be made by email within 3 days of receipt of this form.

Name:  
Email:  
Phone/Ext.  
Street:
City/ZIP
Journal
 Title:		  
Do not use abbreviations.
Volume: No:
Date:         Pages:
Author:
ISSN  
Title of Article:  
Do not use abbreviations.
Cited in:

Notice: The material requested may be protected by Copyright Law (Title 17 U.S. code).

CHECK Student
ONLY Staff/Faculty
ONE Community member

 

CHECK I am willing to pay up to $10.00 by check for the requested material.
ONE I want this item only if there is no charge.
I will not require this periodical after the following date:

For library staff only: 

Due date    RenewalID#

                     

 

 

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