ILL Request

First Name

Last Name

Date

Phone

Address

City/Town

State/Province

ZIP/Postal Code

BCPL Library Card #

Material No Longer Needed After

Requestors of ILL services must be registered members of this library. The library retains the right to refuse a request if proper verification of material cannot be provided by the requestor.

Item Title

Author or Editor

Publisher

ISBN #

0CLC #

Year

I acknowledge that I will be charged $5 for this request if successful

Broome County Public Library

ILL Request