Moultrie Request Form
Please print, complete and fax to
Baldwin Library Fax No. 229-391-4991
Date of Request: _______________________________ MUST have by: _________________
Name: _______________________________________ Class Assignment: □ Yes □No
Mailing Address: ______________________________ Personal interest: □Yes □ No
_____________________________________________
Phone or e-mail: _______________________________ Library Card No.: ______________
Book Request
| Is this book a GILExpress request ? | YES | NO |
Author(s): ___________________________ Call # _____________________________
Title: _____________________________________________________________________
Publisher/Date of Publication: _________________________________________________
Photocopy Request
Author(s): _________________________________________________________________
Title of Article: _____________________________________________________________
Title of journal: _______________________________________________________________
Volume/Issue No.: _______________ Date: _________ Pages: __________________
Delivery Method Preferred
Courier: ____________________________________ Date Sent: ____________________
Fax to Moultrie □ Fax to another number? Fax number _______________________
Source of Reference (i.e.: GALILEO database (which one?), GIL)
Library Use Only:
□Your Request for:
is being sent via _______________________________________________________
and should arrive ______________________________________________________
□Your Request for:
is not available at the Baldwin Library and must be acquired through Interlibrary Loan.
We anticipate delivery within ____________________________________________
4/06