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Chemeketa Community College

Library Book/Media Request Request Form
for Chemeketa Students and Employees

CCRLS Patrons: Please use the Salem Public Library ILL form

Please fill out form completely to avoid processing delays.
Name:
Phone:
Email:
K#:
  Student (currently enrolled):  Faculty  Staff
Title:
Author:
Format: Book:  DVD:  CD:  VHS:  Cassette:
Other:
Source of Reference:
(Ebscohost, Orbis, etc.)
Last date requested item is useful:
We will attempt to acquire the item up until the last date you indicate it is useful. We will contact you if we cannot supply the item by the date needed.
Maximum cost willing to pay: $0:  $5:  $10: Other:
We will attempt to acquire the item for free, or the lowest cost possible. If the cost is greater than the maximum you are willing to pay, we will notify you before continuing the request.
Conditions of Use:
  • I understand that I will be notified by email or phone when item arrives.
  • I will notify the interlibrary loan department if I no longer need the ordered item(s).
  • I am responsible for the safety of borrowed items.
  • I will be billed $.25 per day for overdue interlibrary loan items.
  • I agree to abide by the copyright restrictions on this form.
  • I will be responsible for any fees charged from the lending library even if i do not pick up the item.
I have read and will comply with the conditions above.
Warning Concerning Copyright Restrictions: The copyright law of the United 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.

       




Updated March 2008 by Marketing and Student Recruitment.

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4000 Lancaster Drive NE | P.O. Box 14007 | Salem, Oregon 97309 | 503.399.5000