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Course Reserves Request Form

Please first read the instructions for putting materials on reserve.

Department: *

Course Number: *

Quarter: *

Year: *

How long materials should be available:

Number of Students:

INSTRUCTOR

Last Name: *

First Name: *

Campus Address (Box #): *

Phone: *

Instructor Email: *

ADDITIONAL INSTRUCTOR

Last Name:

First Name:

CAMPUS CONTACT PERSON

Last Name: *

First Name: *

Contact Phone: *

Contact Email: *

Additional Information for Reserves Staff: