Reserve Materials Form

All faculty who wish to place materials on reserve must complete a Reserve Materials form. This form is available as a web form or a PDF that can brought to the circulation desk or emailed to reserves@umassd.edu. For more information on placing materials on reserve, see the Reserve Guidelines.

The web form below can be used to place up to five items on reserve. For more items, use the Reserve Materials form (PDF). Contact reserves@umassd.edu with any questions.

When completing the Reserve Materials form, you must include your full name, the course name and number, and your signature indicating you have read the copyright compliance clause. Please refer to our Copyright Policy for more information.

Instructor Name *

First

Middle

Last

Course Number & Title *

Department & Phone

Email *

Semester *

• Fall
• Spring
• Summer
• Intersession

Year (Fall)

Year (Spring)

Year (Summer)

Item 1 Title

Item 1 Author

Item 1 Call Number

Item 1 Volume/Issue

Item 1 Page(s)

Item 1 Loan Period

• 2 hour loan
• 4 hour loan
• 24 hour loan
• 3 day loan
• 7 day loan

Item 1 Type

• Library copy
• Personal copy
• Photocopy

Item 2 Title

Item 2 Author

Item 2 Call Number

Item 2 Volume/Issue

Item 2 Page(s)

Item 2 Loan Period

• 2 hour loan
• 4 hour loan
• 24 hour loan
• 3 day loan
• 7 day loan

Item 2 Type

• Library copy
• Personal copy
• Photocopy

Item 3 Title

Item 3 Author

Item 3 Call Number

Item 3 Volume/Issue

Item 3 Page(s)

Item 3 Loan Period

• 2 hour loan
• 4 hour loan
• 24 hour loan
• 3 day loan
• 7 day loan

Item 3 Type

• Library copy
• Personal copy
• Photocopy

Item 4 Title

Item 4 Author

Item 4 Call Number

Item 4 Volume/Issue

Item 4 Page(s)

Item 4 Loan Period

• 2 hour loan
• 4 hour loan
• 24 hour loan
• 3 day loan
• 7 day loan

Item 4 Type

• Library copy
• Personal copy
• Photocopy

Item 5 Title

Item 5 Author

Item 5 Call Number

Item 5 Volume/Issue

Item 5 Page(s)

Item 5 Loan Period

• 2 hour loan
• 4 hour loan
• 24 hour loan
• 3 day loan
• 7 day loan

Item 5 Type

• Library copy
• Personal copy
• Photocopy

Signature *

The signee accepts full liability for all photocopies on reserve for the course listed above and certifies that these photocopies were made in compliance with Title 17, §107 of the United States Code. See the Copyright Policy for Reserves for more information.

Date *

Submit