Text Only

Off Campus Access

Off Campus Document Delivery Media Request Form

It may take 5-10 days for you to receive the requested material. The time could be longer.
**Phonograph records must be borrowed in person.**

( Indicates required data)

Media material needed by (date):

MEDIA REQUEST:

Title:

Publisher:

Material Format (CD-ROM or Video or DVD or Computer Disc):

Call Number:

  1. Name of Borrower:
    First:
    Last:

  2. Student ID Number:

  3. Department or Major:

  4. Phone:

  5. E-Mail:

  6. Mailing Address:
    Street:
    City: State: Zip:

    7. >You are:
    (choose one)

  7. If you are an RODP student, enter your RODP Home School:

    8. Additional Helpful Information:

    Read the warning concerning Copyright Restrictions.

    Have you read and agree to adhere to the copyright restrictions? Yes

    Have you reviewed your request? Yes