GIAL INTERLIBRARY LOAN BOOK REQUEST

Staff Use Only

ILL#

OCLC#

Request Date:

Noted on OCLC:

Date rec'd:

Due date:

Due date (GIAL):

Date ret'd:

Shipped by:

Noted on OCLC:

Lending library code:

PATRON NOTIFICATION

Patron notified:

phone on

mail on

ALA REQUEST

ALA#

by

Date sent:

COPYRIGHT COMPLAINCE

CCG

CCL

CHARGES

Supplier Charge: $

Paid

Check#

Sent

Rec'd by

OVERDUE

Contacted #1

Contacted #2

RENEWAL

Requested

Tentative date

Given date

CANCELLED

NOTES

Title:

Author(s)/Editor(s):

Publisher:

Place of Publication:_____________Year:__________

Series Title:

Edition:_______ This edition only

Last date needed:

PATRON INFORMATION

Name: (last)____________(first)____________(MI)__

Address:______________________________________

City, State:____________________________________

Work phone:________________Home phone:________

Status: (check one) GIAL staff student

field personnel center personnel int'l other

CHARGES

The ILL office makes every effort to obtain material from free suppliers. Please indicate below how much you are willing to pay, however, if the lending library does charge.

I will pay $0 up to $15.00 up to $20.00

VERIFICATION (Have you checked the on-line catalog?)

If owned by GIAL: available checked out lost lacks

ISBN:__________________LC#__________________

FirstSearch (OCLC):

MLA:

LLBA:

Linguistics Bibliography:

Other index or Patron's source:

COPYRIGHT

The copyright law of the United States (TITLE 17, United States code) governs the making of photocopies or other reproductions of copyrighted material. Under certain conditions specified in the law, libraries and archives are authorized to furnish a photocopy or other reproduction. One of these specified conditions is that the photocopy or other reproduction is not to be "used for any purpose other than private study, scholarship, or research." If a user makes a request for, or later uses a photocopy or reproduction for purpose in excess of "fair use," the user may be liable for copyright infringement. This institution reserves the right to refuse to accept a copying order if, in its judgment, fulfillment of the order would involve violation of copyright law.

Signature:_________________________Date:________________