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Course Reserve Request Form

Fields marked with an asterisk (*) are required.

Last Name*

First Name*

Department*

Campus Address*

Email Address*

Telephone*

Alternate Contact Info (i.e. assistant, secretary)

Course Name*
(i.e. Introduction to Biostatistics)

Course Number*
(i.e. BIOS 603)

School Med School SPHTM

Can circulate overnight? Yes No

Reserve Start Date*

Reserve End Date*

List items for reserve (up to 8 may be requested through this form):

Item 1
Call Number (if personal copy put "personal")
Author Title
If personal copy, may it circulate overnight? Yes/No

Item 2

Call Number (if personal copy put "personal")
Author Title
If personal copy, may it circulate overnight? Yes/No

Item 3
Call Number (if personal copy put "personal")
Author Title
If personal copy, may it circulate overnight? Yes/No

Item 4
Call Number (if personal copy put "personal")
Author Title
If personal copy, may it circulate overnight? Yes/No

Item 5
Call Number (if personal copy put "personal")
Author Title
If personal copy, may it circulate overnight? Yes/No

Item 6
Call Number (if personal copy put "personal")
Author Title
If personal copy, may it circulate overnight? Yes/No

Item 7

Call Number (if personal copy put "personal")
Author Title
If personal copy, may it circulate overnight? Yes/No

Item 8

Call Number (if personal copy put "personal")
Author Title
If personal copy, may it circulate overnight? Yes/No

Additional Comments/Notes:

Reserve Questions? email medcirc@tulane.edu or call 988-2404
  1430 Tulane Ave SL-86 New Orleans, LA 70112-2699 | (504)988-5155 | medref@tulane.edu