Lucius E. and Elsie C. Burch, Jr. Library

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Interlibrary Loan Request

Full Name(*)
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Library Card Number(*)
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City of Publication
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Date of Publication(*)
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Date Needed By(*)
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BY SIGNING THIS FORM I AFFIRM THAT I HAVE READ THE ABOVE AND ALSO THAT I UNDERSTAND AND AGREE TO COMPLY WITH THE FOLLOWING: To expect a 2 to 6 week average wait, depending upon the item's availability at the supplying library; to pick up and return all loans on time to Collierville Burch Library Circulation Desk; to pay any cost levied by the supplying library for loss, damage or late fees; to realize that I cannot cancel my request once a lending library has been contacted, and that all loans will involve service costs of $2.00 per item; to request renewals at least one week before the due date; overdue fines will be $1.00 per day per item; to acknowledge that I may have no more than four interlibrary loan requests on-going at any time; to pay any additional fees levied by the supplying library, which I would like handled as follows:
Acceptance of Cost(*)
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(if you are 17 or younger you need a parent or guardian's signature)

Town of DemoCollierville
    • Collierville Library Location

      501 Poplar View Pkwy
      Collierville, TN 38017

      Mon – Thu: 10AM – 8PM
      Fri – Sat: 10AM – 6PM
      Sun: 1PM – 5PM
      Phone: 901-457-2600

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