East Central Georgia Regional Library Interlibrary Loan Request for periodical articles To ensure prompt and accurate processing of your request, please complete all sections. Name: PINES Library Card No. (enter without spaces) Phone No. Address Zip Code If you would like to be contacted by email, provide your email address: Article Title Periodical Title Number/Volume Date Page numbers: Source of Reference Is there a date by which you must have this item? Yes No Date required Many libraries charge photocopying fees for articles. Some libraries also charge additional fees. Are you willing to pay additional fees to receive this material? Yes No What is the maximum amount you are willing to pay? At which library would you like to pick up your materials? Choose A Library Appleby Audio-Visual/Talking Book Center Burke County Columbia County Diamond Lakes Euchee Creek Friedman Harlem Headquarters Lincoln County Maxwell Midville Sardis Wallace Warren County By signing this form, I agree that I have read and understand the regulations below. (Indicate signature by re-entering patron name) Add any notes here: Interlibrary Library Loan Regulations • You must have a PINES library card and be in good standing with the library in order to use this service. • Many libraries charge for postage and insurance when they lend their materials, and you will be responsible for those costs. In addition, some libraries charge a lending fee. We will make every attempt to obtain materials from libraries that do not charge additional fees, but please indicate the maximum amount you are willing to pay on the form above. • You will be notified when the material you requested has arrived. Interlibrary loan items usually take at least two weeks to obtain. Please indicate above if there is a date by which you must have the material. • Please pick up your requested items as soon as possible after you have been notified that they have arrived at the library. Fees for postage, insurance, and/or photocopies are to be paid when you pick up the items. Photocopies become the property of the borrower upon payment of the fees and do not need to be returned to the library. • Please return all materials on time. If you need the item for a longer period, contact the library at least five days prior to the item’s due date so we may request a renewal. If the lending library permits, an extension will be granted. The length of the lending period and any extensions are determined by the lending library. Form Verification (type the numbers and letters below exactly like they appear): Powered By ChronoForms - ChronoEngine.com
