Extension Campus / Distance Learning Library Book and Media Request
To be used only for materials known to be in the PBA Library collection.  Please fill out this form completely.  Items must be returned to PBA. Please use the postage paid mailing label and use the same packaging for the return of materials. If they prefer, Orlando campus students may return items to Audrey Kelleher. Please note the due date. The lending period for books is 28 days, plus an additional 14 days for transport (total of 42 days). After the 42 days, late fees apply.
Patron Information
Last Name    First
Mailing Address
State	Zip
PBA ID	Email
Daytime Phone	Classification Select from List Undergrad Student Graduate Student Faculty Administration / Staff
Item Information
I have checked that the PBA Library does own this item No Yes If you haven't checked, Search the PBA Library Catalog now (A new window will open)
Author (or Editor)
Complete Title (Do not abbreviate)
PBA Call Number
Other Information
Comments that may be helpful in connection with this request
Last date item will be of use to you: Date format: YYYYMMDD. Example 20061101 for November 1, 2006

When you "submit," this data will be emailed to the PBA Library Circulation Desk.
If it is transmitted successfully, you should soon see a confirmation form.  Print it for your records.
Thank you for using Palm Beach Atlantic University Library services.