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Instructor's Name:
Reserve Book Room Intake Form

SJDC Libraries
Instructors' Request to Place Material on Reserve

Print out this form.
All fields are required.
Bring completed form to the Circulation Desk with your reserve materials.
Questions? Please call 954-5143.
Thank you.

If you wish, list names of other instructors who are also using this material:

Library Card number:


Campus phone:

Off Campus phone (REQUIRED for Part-time instructors):

E-mail Address:                                                                 

Course Dept & Number (e.g. ENG 001A):

Title of Material on your Syllabus:
Circle one:
  • Personal copy
  • Library-owned copy
Number of copies submitted for:

Goleman # copies:______
South Campus at Mtn House # copies:_______

(Note: All items 20 or more pages must be BOUND. Binding is the responsibility of the Instructor. The Library strongly prefers "Unibind" for its strength and durability. See the Publication Center for binding services.)
Choose a Reserve Material Loan Period (NOTE: If you are submitting more than one copy of a single title, you may designate different loan periods for each copy.):
  • ______ One hour/In-Library Use Only
  • ______ Overnight Loan
  • ______ Two day Loan
  • ______ One week Loan
Date to remove material from Reserve:_______________
Keep material on Reserve Indefinitely?: Yes / No
"Personal copies" will be sent back to Instructors when removed from Reserve Room.
Detailed instructions:Complete one intake form for each title to be placed on Reserve. One form is needed per item unless more than one copy of the item will be placed on Reserve for the same class with the same loan period. Bring the material and the completed form to the library Circulation Desk. Reserve material takes a minimum of 72 hours (M-F) processing time. Please expect 4-day minimum processing time during busy times at the beginning of each semester. If the instructor expects to use the material each semester or each year, then we prefer to have the material remain on indefinite reserve. Indefinite reserve material will be reviewed every two years. Kindly allow 24 hours for library to process requests to remove reserve materials.
Date of Intake:_______________________________________
Library Staff Initial:_______________________________________
All Instructors' Names Input to GoCat?___________________________
Last update: Nov 9, 2015