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Library Home                 Clark College Library Services Course Reserves Request Form
CONTACT INFORMATION (* Indicates required field)
Your Name:*
Phone (555-444-1234):*
Email ( required):*
Campus mailstop:
ITEM INFORMATION (* Indicates required field)
     Format:*Video Book/Magazine
     Loan period:*3 hr Overnight 3 day 7 day
     Should material be security stripped?* Yes No
Material ownership*Pull item from library shelves Sending personal/department copy
Course titles and numbers*
Additional instructors
Put on reserve for*
(Class must be scheduled)
Summer Fall Winter Spring
Campus*    copies at Cannell and/or    copies at CTC
Return to*Library Department OR Other
COPYRIGHT INFORMATION (* Indicates required field)
The Copyright Law of the United States (Title 17, U.S. Code) governs the making of copies of copyrighted materials. Liability for copies placed on course reserve rests with the faculty member. For additional guidance, please see the complete Course Reserves Policy and the Clark College Copyright Policy 675.000.
I have read, understand and agree*
(must be checked to enable Name and Date fields)
Full Name:(signature)*   Date:(mm/dd/yyyy)*
Enter any comments below and press "Submit" to send in your request
Contact: Circulation Staff, MS LIB 112; Phone:(360) 992 - 2504; Email:
See Course Reserves - Instructors for additional information. The complete reserve policy is also available online.
Copyright questions? Contact library course reserve technician or read our copyright policy.
Copyright 2014 Clark College Library Services