Appendix C: Item Purchase Request Form
Date__/____/____ Item Purchase Request
Your Campus: Middletown___ Fauquier___ Status: Student___ Faculty__ Patron___
Name: ________________________________________ Date needed by: ___/____/_____
Contact Me When Item Arrives By: Phone: ____________________
Or
Email: ______________________________________
Item Information (You may attach item information to this form.)
Item Type: Book_______ Journal______ Media______ ISBN: _____________________________
Author: __________________________________________________________________________
Title: ____________________________________________________________________________
Make This Item: Regular Collection_____ Course Reserve____ If For Course Reserves See Reverse
Notes: