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Interlibrary Loan Request
* information is required
*Name  
  *Email  
  Phone number  *Day      Evening 
  *Address  
  *Library card number  
  Need by date (mm/dd/yy)  
Loan information
  *Title  
  *Author  
  *Publisher  
  *Publication year       *Any edition (Y/N)  
  ISBN or LC#  
  Format (book, microform, audiotape, dissertation)  
*Where did you find this citation? (book, journal article, database, catalog)
Will you accept microform, if that's all we can get? (Y/N)  
*Maximum you are willing to pay, if there is a fee  
(0,$5,$10,$15,$20,$25,$30)
Additional notes  

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© 2005 Bethlehem Public Library
451 Delaware Avenue • Delmar • NY • 12054 • (518) 439-9314
last updated: Friday, June 01, 2007