LIBRARY REQUEST FORM

(for Otago Polytechnic staff and students)

This form is for Otago Polytechnic Distance staff and students. University of Otago Distance staff and students should use the University of Otago Distance Services Request Form.

Please contact Distance Library Service if you are unable to complete this form or have any other concerns about requesting items.

Personal details (required)

First Name
Family Name
Delivery address
Town/ City
Postcode	Postcode Finder
Username
Course/ Paper/ Dept
Status	1st year 2nd year 3rd year Postgrad Staff
Email (your Polytech email address)
Phone
Date needed by

Request type

By requesting this item I agree to the following conditions: I require this reproduction for research or private study and I will not use it for any other purpose.