Subject Request Form For Librarians

Please fill out the following form as completely as possible. Items marked with an asterisk must be filled in before the form can be transmitted. When you have completed the form, press the SUBMIT REQUEST button to transmit your request.
Today's Date:
*Original Requesting Library:
*Patron's Name/Request #:
Patron's Daytime Phone or Email Address:
Referring Library Name and Phone Number (include area code):
Referring Librarian's Name:
*Referring Librarian's E-mail Address:
Material Not Needed After This Date:
*Describe the information needed. Be as specific as possible. Include terms or phrases you may have found to describe the subject. If possible, explain how the patron will be using this material. Include level of information needed—Adult, professional, student (include grade or college level).
Sources Already Checked:
* indicates a required field

Copyright: State of Wisconsin Department of Public Instruction
Phone: 1-800-441-4563 (U.S. only) / 608-266-3390