Reserve Audio Visual Request Form

A course syllabus must be on file at Circulation Services. If we do not have one, please submit it with this form.

Processing a reserve request may take at least one work day, and within the first two weeks of the semester, it may take up to four days. Please submit your requests as early as possible.

Please check for the title of thethe media before submitting this request. If the Library does not own the item, please provide us with your personal copy or submit a request for purchase.

Media which cannot be placed on reserves includes:

rented
taped by and individual more than ten days prior to the time it is to be placed on reserves.

Required information is marked with an asterisk (*) and in red. You must include this information or the form will not be submitted.

Name *

Last name	First name

Le Moyne College
Course Number*

(e.g. REL 402, sect. 2)

Le Moyne College
Course Name*

Email address *

Use your full email address - e.g. student@stu.lemoyne.edu or faculty@lemoyne.edu
If you do not have an email address, you may still request items for reserve by filling out the paper reserve request form available at the Circulation Services Desk in Noreen Reale Falcone Library. An email address is required to use the services electronically.

Office Address *

Telephone Number *

Address

City/State/ZIP

After what date will this NO LONGER be NEEDED for reserve?*
Items are automatically removed from reserve at the end of each semester, unless you tell us otherwise before that time.

Please check to see if the Library owns the title prior to submitting a request. If the Library does not own the item, please provide us with your personal copy or submit a request for purchase.

Is the item in SIMON? * yes no

If it is listed in SIMON, please list the
call number and
location .

Type of material: *

Author: * (put n/a if no author is available)

Title: *

Edition: Only this edition? yes no [specify which editions are acceptable in the comments field below]

Publisher: *

Place:

Year: *

Is this a personal copy?
[If yes, please make sure your name
is on the item and print this form and
submit it with the item.] yes no

If yes, please include running time in minutes and general subject Running time

Subject

Is this a gift to the Library? yes no

Additional comments or information:

Questions?
Contact us at Circulation Services

Circulation Services
phone: 315-445-4325