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(* denotes required field)

First Name:
*
Last Name:
*
Middle Initial:

Local Address:
Local Phone:
Home Address:
Home Phone:
Date and time when you would like access to the Rare Book Room:
*
(Must be arranged at least 24 hours in advance.)
Cornell/Research Status:
*
E-mail:
*
Please provide an active address!

MATERIAL REQUESTED:

1.
Call Number:
Title:
*
Author:
2.
Call Number:
Title:

Author:
3.
Call Number:
Title:

Author:
 
Subject of Study/Research:
*
ID Number:

(For Cornell patrons only.)
Please provide additional information (if any):
I agree to abide by the regulations for the use of the Rare Book Room.


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