Drake Library Proxy Borrowing Form

Faculty members may authorize another individual to check out library materials on their behalf by filling out this authorization form.

Your Name Your Name First Last
Your Email
Date Date / MM / DD YYYY
Name of individual authorized to borrow on your behalf: Name of individual authorized to borrow on your behalf: First Last
Their Email
This individual is authorized for the following period of time:

This individual is authorized for the following period of time: Current academic year Until the library is notified otherwise Only this time Other Other
By checking this box, you acknowledge that items will be checked out on your account and you will be fully responsible for any materials borrowed in this way.

By checking this box, you acknowledge that items will be checked out on your account and you will be fully responsible for any materials borrowed in this way. Acknowledged.
Other Notes: