VALE Faculty Reciprocal Borrowing Application Form

The completion of this form is required for borrowing privileges at a cooperating VALE library. By signing this form, you agree to observe all policies of the Lending Library, which may differ greatly from those of your own institution. This is particularly important in relation to circulation periods, overdue fines, and charges for non-return of materials. Please be forewarned: Some of these libraries charge substantial processing fees in addition to the replacement cost of the lost book. You will be personally responsible for any such fees and charges. You must return all borrowed items directly to the Lending Library.

This is a request for borrowing at ________________________________________ (Lending Library).

Name______________________________________________________

Faculty ID #/Barcode#___________________________________

Home Address____________________________________________________

___________________________________________________________

Home Telephone_________________Work Telephone________________

E-mail_____________________________________

Institution____________________________________________________

Department___________________________________________________

Applicant's Signature________________________________________

This Section Filled out by Home Library Staff

I verify that this individual is a faculty or staff member in good standing at _________________________________________________________ (Home Library).

Signed________________________________________ (Authorized Home Library Designee)

Please print name and title________________________________________________

Phone/E-mail:____________________  Authorization Date_______________________

This form is valid for one academic year with an expiration date of June 30th. The Home Library keeps a copy of this form, and the orginal signed form goes to the Lending Library.