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Interlibrary Loan Request Form



Patron Information
Status: UMA Student UMA Faculty UMA Staff
First Name: Last Name:
Barcode from Katz Library borrower
card (14 digits, no spaces):
Email Address:
Mailing Address:
Mailing Address:
City: State: Zip Code:
Telephone (home): Telephone (work):
Item not useful after (mm/dd/yy):
Author:
Title:
Publisher:
Date Published:
Edition:

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