Interlibrary Loan Form

This form is for books only. We cannot obtain audio visual items. Journal Articles can be requested on a different form.

		* indicates a required field
Family Name:		*

First Name:		*

Membership Barcode:		*

Daytime Telephone Number:

Email Address:

Date not wanted after:

Are you are willing to have a large print book if no other copy is available?		Yes No

Author(s):

Book Title:		*

Publisher:

Year of Publication:		(Books published in the last 12 months cannot be requested)

ISBN:

Where did you see it?

Special requirements/comments:

I would like to pickup my Inter Library Loan at:		City Library East Melbourne Library North Melbourne Library

Charges
Most lending libraries charge $13.20 to lend a book. We will endeavour to obtain a book from a library that does not charge. If this is impossible the $13.20 charge will be passed on to the borrower.

If the $13.20 charge applies to the item do you wish the library to obtain the item for you? *		Yes No

The City of Melbourne is committed to protecting your privacy. Any personal information provided to the City of Melbourne on this form will not be used for any other purpose than to request an interlibrary loan. It will not be disclosed to any external party unless required or authorised by law.