Interlibrary Loan Book Request

2. Interlibrary Loan Book Request
   Please complete one form for each request. You will receive a hold notification when the item is ready for pick-up.

   Please complete one form for each request. You will receive a hold notification when the item is ready for pick-up.

4. First Name*

5. Last Name*

7. Library Card Number*

9. Pickup Branch*

   1. Downtown
   2. Bethel
   3. Sheldon

11. Ordering Fee
    If we order this item (filled or not), your account will be charged $5.00. In addition, the loaning library may charge its own fees. What is the total maximum amount you are willing to pay to borrow this item?

    If we order this item (filled or not), your account will be charged $5.00. In addition, the loaning library may charge its own fees. What is the total maximum amount you are willing to pay to borrow this item?

13. We will not order the item if the total fees are higher than this amount.*
    -- Select One --$5.00$10.00$20.00No maximum amount

15. Book Title*

16. Author*

18. Publisher

19. Publication Date

21. ISBN

22. Edition

23. This edition only?

    1. Yes

    1. No

25. Additional Notes or Comments

27. *required field

Leave This Blank:


29. 1. Receive an email copy of this form.
30. Email address

    This field is not part of the form submission.

31. Submit Submit and Print

* indicates a required field