Distance Education

Book, Thesis, and Dissertation Request Form
for McNeese State University Students Only

Please include as much of the following information as possible.

Patron Information

First Name

Last Name

Institution where you receive instruction

Street Address

Work Phone

Home Phone

Fax Number

E-mail

Status
Graduate Student
Undergraduate

Today's Date

Course Number

Item Information

Title of Book, Dissertation,
or Thesis

Author

Publisher

Edition

Date of Publication

ISBN

Call Number
(if available)

Where did you find this information? (source of citation)

The cost should not exceed the following amount: (The usual print/photocopy fee for articles is 10 cents per page. Lending libraries sometimes impose additional fees.)

I do not need this item after: (specify date)