Faculty Periodical Request Form

Fields marked with * are required.

1.*New periodical title to add:

2. Preferred Format:

3. *Annual cost of periodical title (Estimate if exact cost is not known):

4. International Standard Serial Number (ISSN) of periodical (####-####):

5. Publisher:

6. Course names and course numbers this title will support:

7. Have any new courses or programs been initiated in your department within the last 3 years which would benefit from this title?
No Yes
If Yes, please explain:

8. Unique features or coverage in this periodical which make it a useful addition to the Benner Library collection:

9. Is there a periodical title which the library could consider canceling, if necessary, in order to make room for this title?
No Yes
If Yes, give title and reason:

10. Other considerations not mentioned above for adding this periodical:

11. Do you have a sample copy?
No Yes
If Yes, please send a copy to Kathy Boyens, Box 6014.

12. The Department head has approved adding this title:
No Yes

13. *Professor's Name:

14. *Professor's E-mail:

15. *Professor's Phone Number:

16. Department:

17. Should we contact you when the first issue is received (if print) or when internet access has been established (if online)?
No Yes

If you need help filling out this form, contact
Kathy Boyens