KENT LIBRARY: REMOTE STORAGE
BOUND PERIODICALS ORDER FORM

Fields marked with an * are required for the request to be processed.
Electronic submission of this form is encouraged, but you may also submit this form through the mail. Submission of this form through the mail requires that you print this form out, fill in the appropriate fields and mail to the address at the bottom of the page.

*Name *S.S.#
*Street Address:
*City: *State: *Zip:

Filling in as many of the non-required fields as possible will assist in the timely processing of this request.

Request a Journal :

*Title of journal:
Name of article:
Vol.: Number: Month
Year: Page(s):

Request a Government Document:

*Title of Government Document:
*Government Document Item Number

You will be contacted by e-mail and telephone when the requested material arrives.

* E-MAIL ADDRESS:
* PHONE NUMBER:

Comments:


REQUESTED PERIODICALS CAN BE CHECKED OUT FOR 2 HOURS FOR IN-LIBRARY USE ONLY
After two weeks, the materials are returned to storage if not called for.

Click the 'send request' button to send this form via e-mail.

For questions or problems, please contact:
Linda Zimmer
Southeast Missouri State University
Kent Library
One University Plaza, MS 4600
Cape Girardeau, MO 63701
(573) 651-2752
For Library Use Only:
VERIFIED BY: _______________________ DATE VERIFIED: ________________________
FAXED BY: __________________________ DATE FAXED: __________________________
FILLED BY: __________________________ DATE FILLED: __________________________