Extramural Journal Article Request Form
(For Eligible Extramural Students)

Full Name: *
Student ID: *
Address: *
Email address: *	If your email address is entered correctly, you will receive an email confirming receipt of your request.
Course No:
Assignment No:
Title of article:
Author:
Journal Title: * (Please don't abbreviate)
Volume:
Issue:
Pages:
Publication Date:
Information not wanted after this date:
Interloan required:	Yes No
(If material is not held by Massey University Library, indicate if you would like it interloaned from another library. NB: Interloans require PREPAYMENT of $5/item)
Submission of this request amounts to a declaration that you: Require the article for research or private study and will not use it for any other purpose, and Have not previously been supplied with a copy of this reference. This form is for the use of eligible extramural students only.