Physical Items Request: Middle Georgia State University

Faculty Request for Physical Items

Please provide as much information as possible.

Patron Name:*
Status:*		Faculty Staff
Campus:*
Patron Email Address:*
Contact you when item is available in library?:		Yes No
Assisting Librarian (if filling out for patron):
Librarian Email:

For Faculty Use Only:
School of:*

Item 1 Information:
Title:
Format:*
Creator (Author, Publisher, etc.):
ISBN/ ISSN:
Year/ Edition/ Volumes (s):*
Number of Copies:
Price:*
Link/ Additional Information:

Item 2 Information
Title:
Format:
Creator (Author, Publisher, etc.):
ISBN/ ISSN:
Year/ Edition/ Volumes (s):
Number of Copies:
Price:
Link/ Additional Information:

Item 3 Information
Title:
Format:
Creator (Author, Publisher, etc.):
ISBN/ ISSN:
Year/ Edition/ Volumes (s):
Number of Copies:
Price:
Link/ Additional Information:

Item 4 Information
Title:
Format:
Creator (Author, Publisher, etc.):
ISBN/ ISSN:
Year/ Edition/ Volumes (s):
Number of Copies:
Price:
Link/ Additional Information: