Reserves Request Form

Please provide the following information for your reserve request:

Date:
Semester/Year:
# Enrolled:
Department:
Course Number:
Section # *note 'all' for all sections of course
Crosslisted With:
Instructor:
Address:
Phone:
E-mail:
Alternate Contact:
E-Mail:
Phone:

Special Instructions:

MATERIALS LIST:

List below all NEW materials to be included for the course.
List below materials to be RETAINED in the collection from a previous semester.
Or send the list of materials as an email attachment to our Reserves department.
Materials from previous semesters are automatically REMOVED unless included with this request.

Item number 1

Author or editor:

Title: also specify book or AV

Publisher:

Edition/Year:

Steenbock Book Call Number if owned:

Item number 2

Author or editor:

Title: also specify book or AV

Publisher:

Edition/Year:

Steenbock Book Call Number if owned:

Item number 3

Author or editor:

Title: also specify book or AV

Publisher:

Edition/Year:

Steenbock Book Call Number if owned:

Item number 4

Author or editor:

Title: also specify book or AV

Publisher:

Edition/Year:

Steenbock Book Call Number if owned:

Item number 5

Author or editor:

Title: also specify book or AV

Publisher:

Edition/Year:

Steenbock Book Call Number if owned:

in your requests. (The message is sent to steeresv@library.wisc.edu)
ALL fields (Does not send a message.).

Please send comments and suggestions about this form to: Sylvia Pfender