From: Web-server
To: prequest@library.wisc.edu
Subject: Purchase request

_________________________________________

Thank you for submitting your purchase request to UW Madison Libraries.

Please print or file a copy of this page for your records.


Needed by: [date-need]
Title: [title]
Author: [author]
Publication Information: [pubinfo]
Additional comments: [comment]

Following is needed if you wish to be informed when the item is received:
ID: [ID-number]
Your name: [name]
Phone: [phone]
E-mail address: [email]
Department: [dept]
Pickup Library: [pickuplibrary]

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Bibliographer: _______________________ Searcher:_________________________
MADCAT___________   CCAT______________________
LC CTL#_____________   ISBN_______________   OCLC______________________
BIP_________________   BBIP________________   FB________________________ 
REGULAR___    RUSH___      GZM___     DLC___       AC   AE   AV

Edited by:  SWD 1/22/07