Course Reserves Request Form

 

This form is for the convenience of Faculty requesting materials to be placed on reserve at Plough Library for the current semester. Before submitting this form, please check our online catalog to see if the library owns the item. If you have any questions, please call the library at 321-3432.

Submit printed form to Plough Library with materials to be put on reserve.

Faculty Information
Name:
E-mail:
Telephone:
Department:
Request Information
Please submit your request at least 3 days before the item is to be made available to students. This allows the library time to process your request.
Please identify items in the same manner as in your syllabus.
Course Number & Name:
Title of Item:
Author(s):
Copy Source Information:
Type of Material: Book
Class Material
Periodical
Video
Other
Usage:

In Library Use Only (3 hour checkout)
1 Day Checkout
3 Day Checkout
Other

Please provide any additional information:

NOTICE: WARNING CONCERNING COPYRIGHT RESTRICTIONS

The Copyright Law of the United States (Title 17, U.S. Code) governs the making of photocopies or other reproduction of copyrighted materials. All copies accepted for reserve must be made in compliance with the Guidelines for Classroom Copying.

I acknowledge that I understand and am in compliance with the Fair Use Guidelines described in the Fair Use Guidelines for Educational and Reserve Use of Photocopied Copyrighted Materials as reserve reprint(s) item(s). The reserve reprint(s) items that I have placed on Reserve for one term meet these guidelines and/or I have received permission for reproduction.

Instructor Signature (Required) ________________________________________________