Faculty Reserve Request Form

Faculty Reserve Request FormThis form is only for printed material items to be held at the Library’s Circulation Desk. If you have anyquestions on printed material reserves, please contact Circulation at (479) 964-0569. If you wish to place amultimedia item on reserve, please submit the following online form:http://musiclab.atu.edu/facultyreserverequests.htm or contact Dr. Lowell Lybarger at (479) 964-0584.Reserves will be processed as a priority, but may take up to 24 hours to process.Instructor InformationDate of Submission: ________________________________________________________________________Name: ____________________________________________________________________________________Academic Department: _____________________________________________________________________Email Address: _______________________Phone Number: __________________________________Campus Address: ___________________________________________________________________________At the end of the semester, all personal items that have been placed on reserve will be returned to this addressvia Campus mail.Course InformationCourse Name: _____________________________________________________________________________Course Number: _____________________Semester: ______________________________________________ Remove at the end of the semester_______ Remove on the date specified: ________________________________________________________I, __________________________________ understand that the ATU Library will not be held responsiblefor lost or damaged materials that are my personal property.PLEASE FILL OUT THE VERSO OF THIS PAGE

Item InformationLibrary Owned MaterialsPlease provide the author, title, and call number of each item you want to place on reserve.Personal MaterialsPlease mark an “X” in the appropriate column if the item is a personal item.Available Loan PeriodsA. Two hours in-Library use onlyB. Two hours outside Library useC. 24 hourD. Three dayE. One weekPersonalItem# ofCopiesCall Number Author TitleLoanPeriodNOTICE: WARNING CONCERNING COPYRIGHT RESTRICTIONThe copyright law of the United States (Title 17, United States Code) governs the making ofphotocopies or other reproductions of copyrighted material. Under certain conditions specified in thelaw, libraries and archives are authorized to furnish a photocopy or other reproduction. One of thesespecified conditions is that the photocopy or reproduction is not to be “used for any purpose otherthan private study, scholarship, or research.” If a user makes a request for, or later uses, a photocopyor reproduction for purposes in excess of “fair use,” that user may be liable for copyrightinfringement. 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.STATEMENT OF COPYRIGHT COMPLIANCESubmission of this form signifies that I have read and am familiar with the Copyright Revision Act of1976. Submission of this form also indicates that I accept full responsibility in complying with theprovision of the Copyright Revision Act of 1976 that governs the fair use of photocopied materials foreducational purposes.