InterLibrary Loan Request Form

Date*
MM slash DD slash YYYY
PICK UP LIBRARY*
- Richard H. Thornton Library
- Berea Branch Library
- South Branch Library
- Stovall Branch Library
REQUEST TYPE*
- BOOK
- ARTICLE or JOURNAL
- OTHER
AUTHOR*
TITLE (Book)*
COPYRIGHT DATE/ ISBN
TITLE (Article or Journal)
PUBLICATION DATE
PAGE NUMBER(S)
VOLUME NO./ EDITION
Patron Name*
First Last
Library Card Number*
Patron Phone*
Patron Address*
Street Address Address Line 2 City State ZIP Code
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