Name: _________________________________.            Date: ____________.

Department or Program: ________________.

Library Liaison: ______________________.

Amount Requested:  $___________________.

Briefly describe how you will use the funds to meet your library needs
(attach a list of titles to purchase).  For new periodical/journal
subscriptions, please complete a Periodical Subscription Request
Form
(also available from the Library Office).






































Signature of applicant: ______________________
Return completed form(s) to your library liaison or to the library office.