Material Request Form printable pdf download

Material Request Form

Please tell us as much as you can about the material you are requesting.

All requests are subject to approval by our Collection Development Committee.

Title_____________________________________________________________________________________

Author___________________________________________________________________________________

Publisher (optional)________________________________________________________________________

Year of Publication (optional)________________________________________________________________

Additional Information (if any)_______________________________________________________________

_________________________________________________________________________________________

Would you like us to notify you of our decision regarding this material?  Yes

No

If yes, please provide us with your name and email or phone number___________________________

__________________________________________________________________________________________

Return this form to a staff member

For Staff Use Only:

 Main  North County

 East County  South Bay

Please initial and date each field used

Date Received_______________________

Patron contacted (if applicable):________________________________________________________________________

Collection Review______________________________________________________________________________________

Ref Staff Notes__________________________________________________________________________________________

________________________________________________________________________________________________________

Forward to Collection Development_____________________________________________________________________

REV. 01/25/2013

N:\Home\Forms\Patron_Order_Request_Web.pdf

Material Request Form