Distance Education Book Request Form

NOTE: Please fill out the form and mail it to the Distance & Online Education Office or submit it electronically.

Patron Information
Date:
First Name:	*
Last Name:	*
Student ID:	*
Street Address:	*
City:	*
State:	*
Zip Code:	*
Country:
E-mail Address:	*
Phone Number:	*
Send Materials to:	* Home Corbin Danville Lancaster Manchester
Course Information
Course name, course number, location of class and instructor this material is for
Course Name:	*
Course Number:
Location of Class:	* Online student Corbin Danville Lancaster Manchester
Instructor First Name:
Instructor Last Name:	*
If this material is not immediately available, when is the last date we can send?

Books|Reports|Documents

Please limit your request to a maximum of 5 per request. Attach computer printouts from the EKU Online Catalog (eQuest) if submitting this form in person.

Item 1
Author First Name:	*
Author Last Name:	*
Title of book or item:	*
Date of Publication:	*
Location in the Library:	*
Call Number:	*
Status of item:	*
NOTE: If status line indicates Charged, the item is check out to another person.

Item 2
Author First Name:
Author Last Name:
Title of book or item:
Date of Publication:
Location in the Library:
Call Number:
Status of item:

Item 3
Author First Name:
Author Last Name:
Title of book or item:
Date of Publication:
Location in the Library:
Call Number:
Status of item:

Item 4
Author First Name:
Author Last Name:
Title of book or item:
Date of Publication:
Location in the Library:
Call Number:
Status of item:

Item 5
Author First Name:
Author Last Name:
Title of book or item:
Date of Publication:
Location in the Library:
Call Number:
Status of item:

URL: http://www.library.eku.edu/distance/book.php web.library@eku.edu

Last modified: September 11, 2007 | 19:06:41 Validation: CSS | W3C