Course Reserves Request Form
For Copies of Copyrighted Material

I would like your permission to reproduce the following article/book chapter to be put on reserve at the library for a class I am teaching at Oral Roberts University Library, Tulsa, OK 74171. This material will remain on reserve until the end of the semester.

Faculty check all that apply

____  Paper Reserves

____  Electronic Reserves

Department: _____________________________________________ Course Name & Number: _______________________

Semester: _______________________________________________ Year: ________________________________________

Journal Citation:


Book Citation:

Please indicate your approval or denial of this request by signing below and returning as soon as possible. Your reply may be faxed

to ________________________________. Thank you.

______________________________________________________ ______/_________/__________
Faculty Member's Signature Date


Faculty Member's Name (Please Print) ____________________________________________________________________________

Campus Address: _____________________________________________________________________________________________

Phone No.: ____________________________________ Email Address: ____________________@__________________________


Publisher/Copyright Owner check all that apply