Reserve Request Form, Western University of Health Sciences

Reserve Request Form

Materials must be in the Library 24 hours befrore students are notified that the item is on reserve.

If any of the information is missing or the Instructor did not originate request, the item will not be put on reserve.

Library material that is checked out will not be recalled.

If the item is a photocopy of materials directly related to the course curriculum, each page and/or set must be numbered and must be copyright compliant.

Instructor: First Name*

Last Name*: ID:

Email*

Phone #*

My office location

Reserve request location

Course #*

Course Name:

Department*

Item Type*

Video Book Photocopy Other

Viewing instructions for Videos and CD’s

Title of item *

# of copies

Also known as

May be copied*

Yes No

Library use only*

Yes No

Overnight checkout

Yes No

May item be barcoded?

Yes No

Reserve Beginning Date *

Reserve Ending Date *

Delivery*

	Item is owned by the library.
	Will deliver reserve to the circulation desk. (Must be delivered 24 hours before notification that item is on reserve. CD’s must arrive 48 hours prior.)
	Will deliver reserve via inter-office mail. (Must arrive 24 hours before notification that item is on reserve. CD’s must arrive 48 hours prior.)