WMRLS ILL Periodical Request Form

ILL Periodical Request Form:

This form is for use by WMRLS Member Libraries only.

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Fields marked with an asterisk (*) are required, others optional.

NOTE: Entire issues of periodicals do not circulate.

Periodical Information:

Journal:

Author:

Title:

Date (Month/Day/Year ):

Pages:

Volume:

Issue Number:

Date needed by:

*Is the Patron willing to pay photocopy or lending charges?
Yes No

*If "Yes", maximum cost: :

Comments:

Contact Information:

*Library Name :

*Library Contact Person :

*Library Phone Number:
(please include area code)

*E-Mail Address:

*City/Town :

Fax Number :
(please include area code)