教師指定用書申請表.doc

UNIVERSITY LIBRARY Library Reserved Book Request Form Full Name : ______________________ Staff No. : _____________ Faculty: ______________ Ext. : ___________________________ E-mail : ___________________________________________ Academic Year: 20 ____ / ____ Page: _________________ Books / Reprints to be put to Reserve Collection: Item No. Total no. of Pages: _________________ Reserve Period Title Author ＊ Please notify me at the end of the reserve period: □ Yes Call No. Course Code Course Title (tick the appropriate one(s)) 1st Semester 2nd Semester □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ No (Place the library books back to the general rack) Signature : ________________________________ Date : ________________________________ Received by Library Staff : ________________________________ Revision 004