Central University Libraries Southern Methodist University Central University Libraries

Distance Learning

Forms - Book Request

This form is for SMU faculty, staff, and students who do not attend class or work on the SMU campus in Dallas, Texas.

Required information is listed in bold. Please submit a separate form for each item needed. Please provide all the required information; incomplete forms will be returned.

Borrower Information

Name / Affiliation / Contact Information:


Telephone Number

E-Mail Address [full address, user@host]

Library/ID Barcode Number

Department/Program of Study

SMU Affiliation
PhD student
Masters student
Undergraduate student
Other, explain here:

Delivery Information:

Street Address (Line 1) [No PO Boxes]
Street Address (Line 2)

ZIP/Postal Code


Book Information:

Did you search PONI (SMU Library Catalog) for this book?
Yes       No

Author [or put "unknown"]

Does SMU own this item?
Yes       No

Date of Publication


Place of Publication

Comments (can any other edition be used?)
Source of Reference

Date this item is not needed after [mm/dd/yyyy]
This resource is needed for:
research in major field
research in another field
other, explain here:

Regulations / Copyright / Submit Request:

Responisbility for Fines
Document delivery service is provided to SMU distance library users free. All material is due on the date listed on the item. Fines will be charged for overdue ites. These fines will be retained in the user's library bill and fine account for at least one month and then are transferred to the SMU Cashier's Office for collection.

The copyright law of the U.S. (Title 17, U.S. Code) governs the making of photocopies or other reproductions of copyrighted material.
Under certain conditions specified in the law, libraries and archives are authorized to furnish a photocopy of other reproduction. One of these specified conditions is that the photocopy or reproduction is not to be "used for any purpose other than private study, scholarship or research." If a user makes a request for, or later uses, a photocopy or reproductio nin excess of "fair use," that user may be liable for copyright infringement.
This institution reserves the right to refuse to accept a copying order if, in its judgement, fulfillment of the order would violate copyright law.
I, the requester, certify that this request complies with the fair use provision of the copyright law.

Signature [type name]
Date [mm/dd/yyyy]
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