Inter-Library Loan Form

*required information

Requester Information*Full Name*AC Email Address*Phone Number*Department or Mailing Address (Students should put Student Mailbox for the Mailing Address):What Allen College program are you in (e.g., ASR, BHS, BSN...)?What Allen College department are you in (e.g., Nursing Faculty, Staff.)?What is your Allen Hospital job title (e.g., Physician, Nurse, Staff.)?Material Information*Today's Date:*Need by Date:*Material Type:

Journal

Book

Dissertation/Thesis

Audio/Visual

*Journal/Book/Dissertation/Video Title:*Article/Chapter Title:*Article/Chapter Author:*Publication Year:*Journal Volume:*Journal Issue:*Page Numbers:*Are you willing to pay Interlibrary Loan and/or Copyright Fees for this article?:

Yes

*How much are you willing to pay? (Please enter a dollar amount between 0-50):