Please note that this form will need to be completed for every item you wish to obtain through the interlibrary loan service.  Also, you must complete all the necessary parts of this form for the library staff to facilitate your request.  If you need assistance with this form, e-mail a library staff or call 1-(270)-831-9764.  More about the library's interlibrary loan service by going to HCC-ILL.

Patron Information
Requester's First Name: 
Requester's Last Name: 
Mailing Address: 
Telephone Number: 
Email Address: 
Library Card Barcode Number: 
Patron Status:  Faculty Member Mid-Management Classified Staff Student

Type of Request (please select only one):
Book
Magazine/Journal
Video/DVD

Please complete all relevant information about the material you are requesting:

Books
Author (provide the full name): 
Title of the book: 
Publisher: 
Year of Publication: 

Magazine/Journal Article
Journal Title: 
Article Author: 
Article Title: 
Volume Number: 
Issue Number: 
Year of Publication: 
Page Numbers: 

Video/DVD
Video/DVD Title: 
Name of Director: 
Production Company: 
Year of Release: