Letter of Intro Request
If you've contacted a local library to use their print materials and need a letter of introduction, complete all the fields below. You must be a currently matriculated student in good standing at SUNY Empire State College to receive a letter.
Sign in to Google to save your progress. Learn more
First Name *
Last Name *
Name of Library *
The library you wish to use.
Your Mailing Address *
The letter will be sent here
Your Phone Number *
Your Email Address *
Your Student ID # *
This is your ESC username (used to log into ESC courses, etc.). In the form of: Lastname_Firstname### (last 3 characters or numbers)
Your Status at SUNY Empire State College *
Your signature
By typing in your name below, you acknowledge the following (please read carefully):

As a currently matriculated student in good standing at SUNY Empire State College, I would like to use the facilities of the above named library for a time period to be determined by that library.

I understand that I am fully responsible for any fines levied or materials damaged, and that I will abide by the rules and guidelines established by that library. I further understand that if I am granted any borrowing privileges by the above library, I am fully responsible for returning borrowed materials to that library or pay for their replacement.

I also understand that any electronic or online privileges or access to other library services may be restricted by the host library.
Type in your full, legal name *
By typing in my name below, I acknowledge that I have read all of the above in full and that the information provided is current and accurate to the best of my knowledge.
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms