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PINES Library Card No. (enter without spaces)
Address Zip Code
If you would like to be contacted by email, provide your email address:
Source of Reference
Is there a date by which you must have this item? Yes
Many libraries charge photocopying fees for articles. Some libraries also charge
additional fees. Are you willing to pay
additional fees to receive this material?
What is the maximum amount you are willing to pay?
At which library would you like to pick up your materials?
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Audio-Visual/Talking Book Center
By signing this form, I agree that I have read and understand the regulations
(Indicate signature by re-entering patron name)
Add any notes here:
• 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.
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