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Interlibrary Loans Supply
Loan Request Form

for libraries and information agencies worldwide



Sections marked with this red dot must be completed

Requestor Requires

mandatory Service level Core Rush Express
Please provide Loan Quote for Total Cost
mandatoryDate not wanted after

Requesting Library

NUC Symbol (Australia only)
Name of Library (If applicable)
mandatoryName of Institution / Government Dept. / Organisation

Address Details

Delivery Address

PO Box/number/street/etc
Suburb
State
Country
Post Code

Alternative Address Street
Suburb
State
Country
Post Code

Contact Details

mandatoryPhone
Fax
mandatoryEmail

Item Details

Call number (if known)
Title of book / video / conference proceedings / audiovisual items mandatory
Author
in format Surname, Firstname. Separate multiple authors. e.g Smith, Harold and Clay, Mary
Publication Date
Edition
Publisher
ISBN
Source of Reference
Requestor Comments