Library Book or Audiocassette Request
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1. Library Book or Audiocassette Request Form

Please provide all information requested. The fields with a * are required.

If you have questions about filling out this form contact the Information Desk in the library at 816-501-4188.

Please allow 7 business days for receipt of the item. You will be notified by Rockhurst University or Research College of Nursing email when the item is available.

If you are a student assistant submitting a request on behalf of a faculty member, please use the faculty member's information on the form, and add your name to the student assistant field below. The library must have on file a permission form for student assistant before the request will be processed. Open and print this form to give to faculty.

By submitting this form the requestor agrees to be responsible for the above item and to return it by the date due. The requestor understands that s/he is responsible for any fees due to late return, damage or loss of the material. The requestor understands that his/her library account will be blocked until this fee is paid.

*
1. Your Library Card Number:

Note: Your library card number is the 13-digit number at the bottom of your Rockhurst University ID card that begins with "100060".

Your Library Card Number: Note: Your library card number is the 13-digit number at the bottom of your Rockhurst University ID card that begins with "100060".

*
2. Note: Students, Faculty and Staff must use their Rockhurst University or Research College of Nursing email addresses.

Note: Students, Faculty and Staff must use their Rockhurst University or Research College of Nursing email addresses. First Name:
Last Name:
Phone Number:
Email Address:

*
3. Indicate Your Status:

Indicate Your Status: Undergraduate

Graduate

Faculty

Staff

Your Department or Area of Study:

*
4. Material Type

Material Type

*
5. Please provide the following information.

Please provide the following information. Title:
Author:
ISBN:
Publisher:
Publication Year:
Volume Number:
Edtion Number:

6. I will not need this item after
(insert date in the notes):
List any additional notes here:

I will not need this item after (insert date in the notes): List any additional notes here:

Library Book or Audiocassette RequestExit this survey

1. Library Book or Audiocassette Request Form

*1. Your Library Card Number: Note: Your library card number is the 13-digit number at the bottom of your Rockhurst University ID card that begins with "100060".

*2. Note: Students, Faculty and Staff must use their Rockhurst University or Research College of Nursing email addresses.

*3. Indicate Your Status:

*4. Material Type

*5. Please provide the following information.