Brooklyn College Library

E-Reserves Request Form

Use this form for articles, book chapters, class notes, etc. to be scanned and placed on E-Reserves. For tangible copies of books, videos, and other materials to be placed on reserve, please use the form for On-Site Reserves.
Complete the E-Reserve Document Cover sheet for each document placed on E-Reserves.
A copy of your syllabus for each course is required with this form.

Instructor(s)
E-mail address
Phone

Dept/Course Number
(for sequential courses,
please list all)
Course Title
Section #

F SP SU
Term (mark all that apply)
Year

Copyright Compliance

By my signature I confirm that to the best of my knowledge:

my use of the duplicated materials listed falls within the Fair Use provisions of the Copyright Law; or
the materials are in the public domain; or
I have permission from copyright holders to place the material on reserve

Faculty signature: ______________________________________________

Please list the materials you want on E-Reserve on the E-Reserves Document List Form. Reproduced materials not accompanied by a signed Reserve Request List will be returned.
Materials will be returned to you after processing is complete.

FOR LIBRARY STAFF ONLY
Received by ________________ Date /Time __________________
Copies: OK __________ Rejected: Give Reason_____________________________

Bibliographic citations on cover sheet for first page of each document: Yes or No
Syllabus attached: Yes or No
Number of documents submitted ____________________________
Date packet delivered to FDL ____________________

Instructor(s)	E-mail address	Phone
Dept/Course Number (for sequential courses, please list all)	Course Title	Section #
F SP SU Term (mark all that apply)	Year