Authorization Form for Instructional Media Collection
Authorization for Out-of-Library Use By Students
Instructional Media Collection
Instructional Media Collection
Materials housed in the Instructional Media Collection behind the 2nd Floor Periodicals/Media Desk may be taken out of the library for a class presentation with confirmation from your class instructor. Please print this form and have it signed by your instructor before you come into the library to pick up the material.
| Date: | __________________________ |
| Title: | __________________________ |
| Call Number: | __________________________ |
| Borrower: | __________________________ |
| Instructor or | |
| Librarian Signature: | __________________________ |
| Department: | __________________________ |
| Phone#: | __________________________ |
| Due Date: | __________________________ |
| circulation desk clerk initials: | _____________ |
