Decker Library Interlibrary Loan Request
Reference desk telephone: 410-225-2273
Email: refer@mica.edu
Complete one form for each item.
Print legibly!
Name: __________________________________________________
MICA ID __________________________
Status (circle one): undergrad / grad / faculty / postbac / cont. studies / staff
Phone Number or E-Mail Address: ____________________________________________
BOOK / VIDEO / OTHER FORMAT ______________________:
* required fields
* Author: ____________________________________________________________________
* Title: ______________________________________________________________________
Publisher: ______________________________________________ Date:_________________
ARTICLE:
all fields required
Author: ____________________________________________________________________
Article Title: _________________________________________________________________
Periodical Title: ______________________________________________________________
Volume:____________ Number:____________ Date:____________ Page #s:____________
When accepting items, you will be asked to read and sign acknowledging the following:
1. Return of materials to Reference Desk by due date:
I am responsible for returning this material to the Reference Desk at the Decker
Library by the due date displayed on each book’s label.
Use of the library’s book drop is not recommended, nor is it advisable to return Interlibrary Loan items at Circulation Desk.
2. Renewals:
I agree to notify the Reference department one week in advance of the due date
if I wish to request a renewal.
I understand that such renewal is subject to a positive response from the lending library, and that the new due date will be sent to me by the Reference staff when it is known.
I am then responsible for recording the new due date on the book’s label.
3. Overdue fines and/or replacement charges for lost items:
I am aware that if items are returned past the due date, or if items are lost,
there may be fines assessed or replacement fees charged to me by the Decker
Library which are equivalent to the fines and fees charged for Decker materials.
Agreed and item received by patron
(sign) X ______________________________________________