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紹介状申し込み Letter of Introduction Request Form
紹介状が必要な他図書館を利用するため、ICU図書館に紹介状の発行を依頼するフォームです。
This is an application form to request the ICU Library for issuing a letter of introduction to access materials in other libraries that requires submittion of such letters to non-member users.
Email address
IDナンバー ID Number
Your answer
名前(漢字) Name in Kanji (if applicable):
Your answer
名前(アルファベット) Name in Alphabet:
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メールアドレス Email Address:
Your answer
電話番号 Phone Number:
Your answer
ステータス Status:
学年 Grade:
利用希望資料名 Title:
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利用希望館 Library Name:
Your answer
所在情報源 Refered Source:
Required
訪問希望日[第1希望] Date to Visit [1st choice]:
MM
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DD
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YYYY
訪問希望日[第2希望] Date to Visit [2nd choice]
MM
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DD
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YYYY
訪問希望日[第3希望] Date to Visit [3rd choice]
MM
/
DD
/
YYYY
連絡事項 Other Comments:
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