Augusta Richmond County Public Library Interlibrary Loan Request Form
Augusta Richmond County Public Library Interlibrary Loan Request for periodical articles
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? *
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? *
Required
If yes, What is the maximum amount you are willing to pay?
Your answer
Preferred Pickup Library *
By signing this form, I agree that I have read and understand the regulations below. (Indicate signature by re-entering patron name) *
Your answer
Add any extra notes here
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of Augusta-Richmond County Public Library.