Reserve Request Form

Copyright Restrictions

The copyright law of the United States (Title 17, United States Code) governs the making of photocopies or other reproduction of copyrighted material. Under certain conditions specified by law, libraries and archives are authorized to furnish a photocopy or other reproduction. One of these specified conditions is that the photocopy or reproduction is not to be used for any purpose other than private study, scholarship, or research. If a user makes a request for, or later uses, a photocopy or reproduction for purposes in excess of fair use, that user may be liable for copyright infringement. This institution reserves the right to refuse to accept a copying order if, in its judgment, fulfillment of the order would involve violation of copyright law.

1. Semester

Fall Spring Summer Indefinitely (Books and A/Vs Only)

2. Date Needed

Needed By:

3. Item Format

Photocopy Book AV eReserve for ITC Toolkit

Please note: You must register with ITC's Toolkit and grant us permission to load materials into your course file before submitting a request. Check http://toolkit.virginia.edu/displaydocs.html for further information.

4. Complete Citation

Type in the complete citation here, then proceed to #6. (If you are copying and pasting, leave this section blank and go directly to #5.)

Title of Book, Journal, or AV:

Volume or Edition:  Issue:  Pages:  Month:  Year:

Title of Journal Article or Book Chapter:

Call Number (Library Owned Books & AV's Only):

Author(s):

5. Ovid or Virgo Citation

Copy & paste citation from Ovid or Virgo here (one citation per form). If you are not copying & pasting, leave blank, and go to #6.

6. Copyright Policy Compliance

Does your request comply with Copyright Policy of the University of Virginia Financial and Administrative Policy Manual? (Does not apply to books.)

Yes No

7. Availability

8. Comments:

9. Primary Instructor

Name:  E-Mail:

Phone:  Department:  HSC Box #:

Status: Medical Faculty Nursing Faculty Health System Staff Other

10. Alternate Contact Person (if not primary instructor)

Name:  E-Mail:

Phone:

11. Course (if applicable)

Name:  Number:

13. Loan Period (does not apply to Toolkit requests)

2- Hour (external circulation available) 2- Hour (internal use only)

14. Charge Code (only needed for photocopy orders - $3 per item)

Number: