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Augusta Richmond County Public Library Interlibrary Loan Request Form
Augusta Richmond County Public Library Interlibrary Loan Request for periodical articles
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* Indicates required question
Name
*
Your answer
PINES Library Card No. (no spaces)
*
Your answer
Phone Number
*
Your answer
Address
*
Your answer
Zip Code
*
Your answer
Email
Your answer
Article Title
*
Your answer
Periodical Title
*
Your answer
Number/Volume
*
Your answer
Date
*
MM
/
DD
/
YYYY
Page Numbers
Your answer
Source of reference
Your answer
Do you need this item by a certain date?
*
Yes
No
Required
If yes, by what date?
MM
/
DD
/
YYYY
Many libraries charge photocopying fees for articles. Some libraries also charge additional fees. Are you willing to pay additional fees to receive this material?
*
Yes
No
Required
If yes, What is the maximum amount you are willing to pay?
Your answer
Preferred Pickup Library
*
Choose
Headquarters Branch
Appleby Branch
Diamond Lakes Branch
Friedman Branch
Maxwell Branch
Wallace Branch
By signing this form, I agree that I have read and understand the regulations below. (Indicate signature by re-entering patron name)
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Your answer
Add any extra notes here
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