Book    Videotape  Periodical Subscription   Other:

Author:    

Title:        

Publisher:                                     Year:

ISBN:        Edition:              Vol:                Cost:

ISSN:

Requestor:   Ext:       e-mail:

Course No./Title:    Dept.

Needed by: (please specify term if needed for course)

Additional Information: (please send/include pertinent reviews, citations, or other identifying information if available):

Thank you for your input.  You will be notified of the status of your purchase request.