Staunton Public Library card holders may use this form to request materials not found in the Valley Libraries Connection Catalog. The length of time it takes to receive a request varies depending upon availability of the item. If the item you are looking for is less than a year old, you might want to fill out the “Request for Purchase” form online. You may also want to explore our online databases which provide access to many books and articles. There is a limit of 3 open requests per patron (microfilm is limited to 5 reels max per patron). You must have a zero account balance before we place your request.

1

I am requesting a:

 *

I am requesting a:

Book

Article

Audio

Video

Microfilm (5 reel limit)

2

Fill out as much information as you can about the item. We require at minimum the title and author. If you want a particular edition or publication date, please include that information. 

 *

Fill out as much information as you can about the item. We require at minimum the title and author. If you want a particular edition or publication date, please include that information.

Title:

Author:

Date Published (Year):

Publisher:

For articles: include Name of Periodical, Month/Year, Volume/Issue, and what Pages you need.

3

Please give us your contact information. We will contact you by either telephone or email regarding your Interlibrary Loan request.

 *

Please give us your contact information. We will contact you by either telephone or email regarding your Interlibrary Loan request.

Your Name:

Library Card #:

Address:

Phone Number:ext.

Email:

You are responsible for the cost of postage to return your item to the lending library, generally between $4 and $6. In the event that a lending library sends a bill for lending fees after you have picked up an item, you are responsible for those fees, even if they exceed the amount entered below. The lending library will determine the replacement cost of any lost or damaged material as well.

4

If there is an additional charge imposed by the lending library I will pay up to:

 *

(Monetary amount willing to pay in excess of postage)

5

I understand the fees and responsibilities outlined above. I agree to pay postage and any additional charges if the Library is able to procure my request.

 *

I understand the fees and responsibilities outlined above. I agree to pay postage and any additional charges if the Library is able to procure my request.

Yes

No

6

Please type in your initials in lieu of a signature.

 *

Initials:

1. To receive a copy of your submission, please fill out your email address below and submit.
2. Email Address

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