TODAY'S DATE

 

PERIODICAL TITLE

ARTICLE TITLE

    VOL   NO.   PERIODICAL DATE

    PAGE NUMBER(S)

 

    PERIODICAL INDEX

 

    PATRON'S NAME

    TEL NO.

 

    DATE NEEDED (allow three weeks for delivery)

    NOT NEEDED AFTER (date) 

 

   WILL YOU ACCEPT CHARGES FOR PHOTOCOPIES?

     MAXIMUM YOU WILL PAY

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