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Northwest Missouri State University


Photocopied Reserve Request Form

Important!! Please complete all sections of this form. Do not use abbreviations.
If you have any questions about Reserve services, please contact Terra Feick at 562-1195.

 

Faculty Information:

Name of Instructor Required
Instructor's Bearcat ID# Required
University E-mail Address Required
Phone (campus extension) Required
GA's name, if applicable

Copyright:

  • During the first trimester material is on reserve, the library staff will attempt to obtain copyright permission for materials that will be placed on reserve for additional trimesters. If they are not able to obtain copyright permission, faculty will have the responsibility for obtaining that permission. Sample letter.
  • This material may be protected by Copyright Law (Title 17 US Code). I understand that the responsibility for compliance with the copyright law rests solely with me, the faculty member who has placed photocopied materials on reserve. (For more information on copyright click here)

    I have read and understood the copyright statement. Required

Materials Information:

  • Photocopies, which will be provided by the instructor, should be straight, clean copies with 1-inch margins and no solid black areas.
  • The boxes below must be filled out completely before items will be processed for Reserve use.
  • Photocopies listed on this request form should be delivered to the Library Services Desk or sent via campus mail to Sharon Samson, OL110, as soon as possible after completing the form.
  • Loan periods are 2 hours for 2-hour in-library use only; 4 hours for 4-hour in-library use only; overnight for items that are due the next day, 15 minutes before the library closes; 3-day for items due in 3 days, 15 minutes before the library closes; and 7-day for items due in 7 days, 15 minutes before the library closes. Fines are $.50 per hour.
  • Items will be removed from Reserve and returned to instructors at the end of the current trimester unless otherwise noted (use "remove date" field to indicate later removal).

Required for each item to be placed on reserve

Course-Section (list all)

Citation information for copyright permissions

Total number students Publication title
Required reading? Published by
Author Publication date
Article or chapter title
Volume/Issue number
Number of copies Pages
Loan Period ISBN/ISSN
Students need by date  
Remove date


Required for each item to be placed on reserve

Course-Section (list all)

Citation information for copyright permissions

Total number students Publication title
Required reading? Published by
Author Publication date
Article or chapter title
Volume/Issue number
Number of copies Pages
Loan Period ISBN/ISSN
Students need by date  
Remove date


Required for each item to be placed on reserve

Course-Section (list all)

Citation information for copyright permissions

Total number students Publication title
Required reading? Published by
Author Publication date
Article or chapter title
Volume/Issue number
Number of copies Pages
Loan Period ISBN/ISSN
Students need by date  
Remove date


Required for each item to be placed on reserve

Course-Section (list all)

Citation information for copyright permissions

Total number students Publication title
Required reading? Published by
Author Publication date
Article or chapter title
Volume/Issue number
Number of copies Pages
Loan Period ISBN/ISSN
Students need by date  
Remove date