The library permits a faculty member to authorize individuals to charge out materials in the faculty member's name. This permission is extended as a courtesy to the faculty member and should be used only when obtaining materials for the faculty member to use directly. When an individual is obtaining materials for his own use, such materials should be charged out in the individual's name according to his personal library privileges. A faculty member is responsible for all materials charged to this authorization.
Please allow the following individual, ________________________, to charge out materials in my name for my use during the period of time from ____________(mon/day/yr) to ___________(mon/day/yr).
Note: maximum of 12 months.
| Faculty Member's Name |
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| Department |
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| Building |
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| Signature |
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| Date |
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| Telephone Number |
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Print this form and return to:
Access Services Department, Main/Science Library, Campus
OFFICE USE ONLY |
| Patron Number |
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| Valid-to-Date |
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| Date Assigned |
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