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Tomlinson Library Faculty Proxy Request
CMU faculty may use this form to designate a CMU-affiliated proxy, such as an administrator, teaching assistant, student work-study, or intern, for purposes of checking out library materials or picking up Interlibrary Loan items. The designated proxy must bring their own photo ID and the faculty MAVcard to the Checkout & Reserves Desk to check out materials.

For help completing this form, contact the Checkout & Reserves desk at 970.248.1244.

View this form at http://bit.ly/mavproxy.

Faculty Name *
Your answer
Faculty 700# *
Your answer
Faculty CMU Email Address *
Your answer
Faculty Preferred Phone Number *
Your answer
Proxy Name *
Your answer
Proxy CMU Email *
Your answer
Begin date of proxy authorization *
MM
/
DD
/
YYYY
End date of proxy authorization *
MM
/
DD
/
YYYY
I authorize my proxy to do the following: *
Check all options that apply.
Required
Acknowledgement of Responsibility *
Required
Acknowledgement of MAVcard use *
Required
Anything else?
Feel free to let us know any other information that helps us process your request.
Your answer
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