Reserve Request Form
Please submit one request form per item. (This allows for varying reserve periods of different materials and/or to coincide with when assignments are due during the semester.) Please allow up to 3 days for items to be placed on reserve.
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Contact Information
Instructor's Name: *
CCCC Library Card Number: *
Curriculum Program: *
Course Number & Name: *
Material to be Reserved
Title & Author of Material: *
ISBN Number or Library Call Number: *
Number of Copies (if applicable):
Is this material a library copy or a personal instructor copy? *
If material is a personal instructor copy, please give estimated value/cost:
Reserve Terms & Instructions
In which library should this reserve material be placed? *
Required
Date material should be placed on reserve: *
MM
/
DD
/
YYYY
Date material should be taken off reserve: *
MM
/
DD
/
YYYY
How long should material be checked out? *
Special Instructions:
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