Stratton Taylor Library Interlibrary Loan Request

Date Requested: Patron Name : Select one: WRL Patron STL Library Patron Other Library Card Number: Email: Phone : What would you like to request? Check all that apply.
Book: ____ Article: ____ DVD, CD, or Videotape: ____ Special Items: ____ _____________________

Complete this section to request a book:
Book Title: Author: Publisher: Publication Date: ISBN:

Complete this section to request a journal or magazine article:

Journal/magazine: Article Title: ISSN: Author: Volume: Number: Publication Date: Pages:

Complete this section to request CDs, Videotapes, or DVDs:
CD, DVD, or Video Title: This item is a: (check one) CD ___ DVD___ Video ___ Other ___ Please provide any other information that will help us identify the CD(s), DVD(s), Videotape(s) or other special item(s) you want to request.

Tracking Check one: Approved: ___ Disapproved: ___

Due Date: Date Completed:

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