Print this form, fill it out, and bring it to the library.

	Request to Borrow a
	Book, Video or Cassette
	from another library
	Have you looked for this book in our library?	Yes ___	No___
	Have you checked our On-line Catalog?	Yes___	No___
	Please print clearly
	Date_________________________
	Your Phone #:________________________
	Your Name:__________________________
	Address: ____________________________
	City/Zip:_____________________________
	If the name or address on yourlibrary card is different from the above information or if you do not have a library card please tellsomeone at the circulation desk when you submit this request.
	Author(s) : ________________________
	Title: _____________________________
	Publication Year: ________
	Where did you hear about this book?
	____________________________________
	____________________________________
	For Staff Use Only: