Material Request Form
Requested materials must be tied to a course or program.
FUNDING DOES NOT PERMIT PURCHASES FOR PERSONAL INTEREST.
All requests require the approval of your Department Chair or Dean.

Please allow 6 to 8 weeks for servicing this request.
Personal Information
Status: *
Name *
E-mail *
MUST USE PGCC EMAIL ADDRESS
Phone *
(Home / Work / Campus Ext)
Department / Club Association *
Request Item
Format *
Title *
Author / Director *
ISBN
Publisher *
Copyright Date *
In what course or program will the item be used? *
Do you need this item by a specific date? *
If yes, please enter the date
MM
/
DD
/
YYYY
How did you find this item? Review, article, catalog… Please enter source information below:
If you have an URL, please copy and paste it below:
Please provide justification for this purchase: *
Please select your Dean or Chair for approval purposes: *
Submit
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