Instructor:         Date:    
Department and Course Number: (as shown in Timetable)   

Team-taught Course?

Contact Person:           Additional Names of Team: 

• EXCERPTS FROM BOOKS: CITE AUTHOR, TITLE, PUBLISHER, AND DATE
• EXCERPTS FROM PERIODICALS: CITE JOURNAL, VOLUME, DATE, AND ARTICLE AUTHOR

Please fill in the appropriate columns below; you may request up to 5 items at a time.  Please scroll down and click the submit button when you are finished:

Author: (Last, First, MI)
Title: (Please do not abbreviate)

Loan Period:
2-hour (library use only)  1-day        3-day    7-day     E-Reserve

Number of Copies:   

Type of Material:
Photocopy*     Textbook Rental     Personal Copy* Murphy Library Book-- (Include call number )
E-Reserve (email e-reserves to cirser@uwlax.edu)

*Please drop these off at the library Circulation desk. (You can still use this form.)

Author: (Last, First, MI)
Title: (Please do not abbreviate)

Loan Period:
2-hour (library use only)        1-day        3-day    7-day     E-Reserve

Number of Copies:    

Type of Material:
Photocopy*   Textbook Rental     Personal Copy* Murphy Library Book-- (Include call number )
E-Reserve (email e-reserves to cirser@uwlax.edu)

*Please drop these off at the library Circulation desk. (You can still use this form.)

Author: (Last, First, MI)
Title: (Please do not abbreviate)

Loan Period:
2-hour (library use only)        1-day        3-day    7-day     E-Reserve

Number of Copies:    

Type of Material:
Photocopy*     Textbook Rental     Personal Copy* Murphy Library Book-- (Include call number )
E-Reserve (email e-reserves to cirser@uwlax.edu)

*Please drop these off at the library Circulation desk. (You can still use this form.)

Author: (Last, First, MI)
Title: (Please do not abbreviate)

Loan Period:
2-hour (library use only)        1-day        3-day    7-day     E-Reserve

Number of Copies:    

Type of Material:
Photocopy*     Textbook Rental     Personal Copy* Murphy Library Book-- (Include call number )
E-Reserve (email e-reserves to cirser@uwlax.edu)

*Please drop these off at the library Circulation desk. (You can still use this form.)

Author: (Last, First, MI)
Title: (Please do not abbreviate)

Loan Period:
2-hour (library use only)        1-day        3-day    7-day     E-Reserve

Number of Copies:    

Type of Material:
Photocopy*     Textbook Rental     Personal Copy* Murphy Library Book-- (Include call number )
E-Reserve (email e-reserves to cirser@uwlax.edu)

*Please drop these off at the library Circulation desk. (You can still use this form.)

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