Information Technology Division
George C. Gordon Library

Distance Learning Book Requests

If you have read all of the instructions on this page, you may skip to the form.

Please be sure to enter your full name and your full email address (e.g., username@wpi.edu) below to allow us to efficiently process your request. You will also need to enter your library patron identification number, so it would be best to use this form in secure mode.

Distance learning students wishing to take advantage of the automated loan facilities to request a copy of an original work must register their intent to use this service by the completion of a "Copyright Declaration for Electronic Requests." Electronic requests will only be processed by library staff if this declaration has been received by the Distance Learning Library Services Office. This copyright declaration form must be completed and submitted at the beginning of each academic year.

Distance learning students are permitted to borrow up to 10 items (books and journals) at a time. This form allows for five (5) books to be requested at a time. Required fields indicated with an *.

Copyright Declaration (U.S. Copyright Law of 1976, Title 17, Section 108) and WPI's Copyright Compliance Policy
I require this copy for the purpose of research or study and will not use it for any other purpose. I have not previously been supplied with a copy of this or other work. I agree to abide by the registration and Copyright Declaration I have signed that is on file at the George C. Gordon Library.

Name:
ID Number:     (example: 123456789)
Email:*
Telephone:
Fax:


Book 1

Author:
Title:*
Publisher:
Published Date:
Edition:
Source of reference:
No longer required after this date:

Book 2

Author:
Title:
Publisher:
Published Date:
Edition:
Source of reference:
No longer required after this date:

Book 3

Author:
Title:
Publisher:
Published Date:
Edition:
Source of reference:
No longer required after this date:

Book 4

Author:
Title:
Publisher:
Published Date:
Edition:
Source of reference:
No longer required after this date:

Book 5

Author:
Title:
Publisher:
Published Date:
Edition:
Source of reference:
No longer required after this date:

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Last modified: Feb 26, 2007, 12:00 EST
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