College of Eastern Utah
Inter-Agency Loan Book Request Form
Title  
Call#  
Date needed by:  
 
Patron Information
Patron First Name  
Patron Last Name  
Library Card: 2 3176 000
(please enter last 6 digits)		  
 
Address  
City  
State  
Zip
nnnnn or nnnnn-nnnn		  
 
Phone
nnn-nnn-nnnn or (nnn)nnn-nnnn		  
 
Email  
I understand that it will take 3-4 working days to receive items requested from other branches.