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ILL/DDS Request for Book

CCC Faculty, Staff, and Students Only
Phone: 575.769.4080
Kelly Gray: 575.769.4179
Please enter today's date:   

Name:  
(Last Name, First Name, Middle Initial)

Department/Major:  

Campus Box or Mailing Address: 
 

Email:          
(Use your full email address, e.g., jdoe@clovis.cc.nm.us)

Date no longer needed:  

Please allow 1-4 weeks for materials to arrive. We will notify you when the materials arrive.

Your Academic Status 
Faculty
Professional Staff
Classified Staff
Ph.D. Student
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  I will be willing to pay 

Nothing
Up to $5.00
Up to $10.00
Up to $20.00
Over $20.00

 

Author of Book:  

Title:                      

Place of Publication:  

Publisher:            

Date/Edition:      This edition only 

ISBN:                   

Source of Citation - Include original citation if possible: 
 

Indicate title of chapter or article within the book and pages needed:
 

Type of Document -- If your request is for a dissertation, thesis or government document,
please check the appropriate line.

Dissertation Thesis Government Document     

SuDoc Number:  

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