Reserve Materials: Request Form

Instructor name (first, middle, last)*:

E-mail address*:

Telephone*:

Department*:

Campus mail box:

Course:

Course number: Section:

Semester/year:

Book or book chapter

Title:

Author/editor name (last, first):

Place of publication:

Publisher:

Publication date:

Chapter author(s) if applicable:

Chapter title(s) if applicable:

Page range(s) if applicable:

URL if applicable:

Call number, if available:

Type of reserve: Print only Electronic only Both

Journal article

Journal title:

Article title(s):

Article author(s):

Volume: Issue: Date: Page range(s):

URL, if applicable:

Type of reserve: Print only Electronic only Both

Homework solutions, notes, etc.

Title as students will request it:

Type of reserve: Print only Electronic only Both

Password protection

Password (mandatory)**:

Characters Verification:

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