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Course Reserve Request Form

Instructions

Please complete and submit the form below at least two weeks prior to the beginning of the course (or before use is anticipated for a particular item).

The following information is required

  • Course title and number
  • Instructor's name or a contact person if other than the instructor
  • Author, title, publisher, date of publication, and Upstate Library call number (if known) for each item.
  • Full citation for reprints
  • Dates when materials should be placed on and taken off reserve

Patron Information:

Instructor's Name
Department
Phone/Beeper
Email

Course Information:

Course Name
From (Date)
Number
To (Date)

Reserve Information:

Journal Title
Title of Article
Author
Year
Month
Volume
Issue
Pages

Book Title
Author
Publisher
Date
Chapter(s)
Pages
Call #

Additional Comments:
 
 
Health Sciences Library
SUNY Upstate Medical University
766 Irving Avenue
Syracuse, N.Y. 13210
Phone: 315 464-7091