Purchase Request Form

Item Information

1. Title: [required]
2. Author (please list author with last name first, i.e., Smith, John):
3. Publisher:
4. Publication Date (please use a dash (-) when entering the date, e.g. 03-2007):
5. Edition:
6. ISBN #:
7. Price (in $):
8. Format: Book DVD/Video CD-ROM Other
9. How does this item fit into the MSU Libraries Collection? [required] Useful for Courses:   Course Catalog
   Supports Research of:
   Other:
10. Additional Information: (Characters not allowed: #  $  ^ \\ | < > `)

Requestor Information

1. Name: [required]
2. Status: [required] -select current status- Freshman Sophomore Junior Senior Graduate Student Faculty Staff Other Student Other/General Library Patron
3. Department: [required]
4. Email Address: [required]
5. Campus/Local Phone: [required]
6. Do you want to be contacted when this resource becomes available? Yes No
7. Do you want an email copy of this form? Yes No
8. Ignore field (test for robot):

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