Book Reserve Request Form: Tufts University Hirsh Health Sciences Library

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Book Reserve Request Form

Please use this form to place books on reserve. Please use the comments section to note if the Tufts Libraries do not own the title.

In addition to the copy of this form that is displayed on your screen after sending, you will receive a personal email confirmation from a Public Services staff member to verify receipt of your request.

* Required Information

*Instructor's Name

* School

If other, please enter here:

*Course Title:

*Telephone:
(use the form 555-555-5555)

*E-Mail:

Department:

Course Dates:

From: To:

Will this course be repeated each year? Yes No

Instructor Comments:

Author(s) or Editor(s)	Title	Date or ED.	Publisher	Call No.

The copyrighted materials which I am submitting to the Reserve Room at the Hirsh Health Sciences Library for student use for the above class and semester are in compliance with the Copyright Law (17 U.S. Code).
See further information on copyright.

* I understand and agree with this statement



	Tufts University Hirsh Health Sciences Library 145 Harrison Ave., Boston, MA 02111 phone 617.636.6705 \| fax 617.636.4039 \| Comments and suggestions to hhsl@tufts.edu

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