Suggestion to Purchase / Interlibrary Loans Form

Fields marked with * are mandatory.

Title: Mr. Mrs. Ms.

*First Name:

*Surname:

*Library Card Number:

*Email:

Phone #:

Request Type: Interlibrary Loan Suggestion to purchase

Title/Subject/Series:

Author/s:

Publication Details: Publisher, date of publication, ISBN

Format: Book Large Print Audio Books Other

Further Details: Journal article title, date, volume, page #

Where did you learn about this title?

Last date needed by:

*Pickup Location: Ipswich Redbank Plaza Redbank Plains Mobile Library

All requests incur a $0.60 Reservation Fee. If you're requesting an Interlibrary Loan and we are unable to get it from a public library, then a charge of $13.20 will apply

Are you willing to pay this? No          Yes