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Hebert Public Library
Interlibrary Loan Photocopy Request Form

Fields marked by "*" are required.

NOTICE: WARNING CONCERNING COPYRIGHT RESTRICTIONS The Copyright Law of the United State (Title 17, United States 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 or 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 reproduction for purposes in 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 judgment, fulfillment of the order would involve violation of copyright law.

I have read the copyright statement and agree to comply with these restrictions. (Failure to check this box will cancel your request.)
* I agree


* Last Name:

* First Name:

* Mailing Address:

* City:

* State:

* Zip:

* Daytime Phone:

* Evening Phone:

* Hebert Library Card Number:

E-Mail Address:


Note: Because we are getting this material from another library system, it may take approximately one to four weeks for the material to arrive. When a requested book has arrived on loan, you will be notified that it is ready to be picked up.


Material is not needed after the following date (mm/dd/yyyy):

* This is a request for a PHOTOCOPY of a:
    Other format:  

* Journal/Newspaper/Proceedings Title:

Author(s) [Last name(s) first]:

* Article Title:

* Volume:

Issue Number:

* Publication Date:

Page Number(s):

ISSN:

I am willing to pay up to the following amount to receive this material:

Notes to ILL Dept:


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