Book/Media Request

Library:

Request Number:  Date:

Date not needed after:

Patron Name:

Patron Barcode:  Patron Phone:

Patron Address:

City, zip:

Library Staff E-mail:

Author:

Title:

Publisher:  Date:

Accept Different Edition Yes  No

ISBN: 

Format 

Verifications:

Duluth Public Library  Not available

Found on MnLink  Yes  No

Available from  UMD  St. Scholastica

Found on OCLC/Worldcat Yes  No

OCLC# 

Notes/special instructions