INTERLIBRARY LOAN REQUEST FORM

Inter-library loan service is free, however, special borrowing fees, or insurance are the borrower’s responsibility. Costs will be charged to the borrower, even if the items are not picked up. Interlibrary loan items accrue an overdue charge of .50 per day. There will be a minimum $50.00 replacement fee for any lost or damaged items.
I agree*
- I agree to pay any lending fees or insurance costs at checkout. I understand that any costs will be disclosed before materials are ordered. Most requests do not incur lending fees or insurance costs.
DATE OF REQUEST:
MM slash DD slash YYYY
TITLE:
AUTHOR:
FORMAT:
ISBN:
Maximum insurance or special borrowing fees patron will pay:
Date item is needed:
MM slash DD slash YYYY
Specific edition:
Where will you pick up your ILL?*
PATRON INFORMATION
NAME:*
First Last
PHONE:*
ADDRESS:
Street Address Address Line 2 City State ZIP Code
LIBRARY CARD NUMBER:
*
- I agree to accept all responsibility for all items borrowed, including replacement if necessary. *
Signature*
DATE:*
MM slash DD slash YYYY
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Comments
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