Isothermal Community College Library
Book Request Form
First Name
What's your name?
Last Name
What's your last name?
E-mail Address
Valid E-mail please
Home Phone
555-555-5555
Work Phone
555-555-5555
Affiliaton with ICC
Student - List Major
Faculty/Staff - List Department
Non-Student - County
Charges
If the lending library charges a fee, do you still want to request this item?
Yes
No
Maximum you are willing to pay
$
Whole dollar amount
Book Information
Author
Who is the Author of the book?
Title
What is the title of the book?
Publisher
Who published the book?
Publication Date
When was this book published?
ISBN
If you know it.
Return By
After what date will you not need the book?
