Periodical Request Form

Please fill out the following application and then submit at the bottom.
Forms completely filled out process faster than incomplete forms.

(*) denotes a required field

Requester Information
Note: You must be a CCSU faculty member, CCSU staff member, or CCSU student to use this service.
Faculty Staff Undergrad Grad Other

Your Name - Last name, First name (*)

Mailing Address (*)

E-mail - Enter your CCSU e-mail address. This will be your BlueNet ID followed by @ccsu.edu (e.g., borrower_ill@ccsu.edu).
Phone

Deliver by:

Will Pick Up Electronic Delivery

IMPORTANT NOTE: If you select Electronic Delivery as the delivery method we will send you an email message when the document is available. You will then be able to access the document through your web browser. You will need to have Adobe Acrobat installed on your PC (most campus PC's have this by default). For more information on this service visit the FASTDoc Page. Be sure to include your complete Internet email address in the E-mail address area above (example: username@ccsu.edu).

(*) I have checked that Burritt Library does not have this item No Yes If you haven't checked, please check the library's holdings now. You must check "Yes" for the form to be processed.

Item Information

Periodical Title (Do not abbreviate!) (*)

Author's Name (Last, First)
Volume
Number

ISSN
Date (*)
Pages (*)

Title of Article (*)

Other Information

Where I found this information (print index, book or electronic database):

If a print source, include page and year:
If a database, include search keywords:

Most material will take approximately two weeks to arrive. If you have not heard from us within three weeks, please contact the Interlibrary Loan Office (832-3408).

WARNING CONCERNING COPYRIGHT RESTRICTIONS (*) The copyright law of the Unites 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 purposes in excess of "fair use," that 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. I agree to comply with these restrictions. (Failure to check "Yes" will cancel your request.) No Yes

If you have any questions, please contact the Interlibrary Loan Department
via telephone to (860) 832-3408. Thank you for using Elihu Burritt library services.

Requester Information Note: You must be a CCSU faculty member, CCSU staff member, or CCSU student to use this service. Faculty Staff Undergrad Grad Other
Your Name - Last name, First name *()**
Mailing Address *()**
E-mail - Enter your CCSU e-mail address. This will be your BlueNet ID followed by @ccsu.edu (e.g., borrower_ill@ccsu.edu).	Phone
Deliver by: Will Pick Up Electronic Delivery IMPORTANT NOTE: If you select Electronic Delivery as the delivery method we will send you an email message when the document is available. You will then be able to access the document through your web browser. You will need to have Adobe Acrobat installed on your PC (most campus PC's have this by default). For more information on this service visit the FASTDoc Page. Be sure to include your complete Internet email address in the E-mail address area above (example: username@ccsu.edu).
*()** I have checked that Burritt Library does not have this item No Yes If you haven't checked, please check the library's holdings now. You must check "Yes" for the form to be processed.
Item Information
Periodical Title (Do not abbreviate!) *()**
Author's Name (Last, First)	Volume	Number
ISSN	Date *()**	Pages *()**
Title of Article *()**
Other Information
Where I found this information (print index, book or electronic database):
If a print source, include page and year:	If a database, include search keywords:

Most material will take approximately two weeks to arrive. If you have not heard from us within three weeks, please contact the Interlibrary Loan Office (832-3408).
*WARNING CONCERNING COPYRIGHT RESTRICTIONS () The copyright law of the Unites 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 purposes in excess of "fair use," that 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. I agree to comply with these restrictions. (Failure to check "Yes" will cancel your request.)** No Yes