<h2>Reserve Book Chapter(s) Request<br /></h2>
<ul>
<li>This service is <strong>restricted to SIUE faculty</strong>.</li>
<li>This form is for <strong>chapters of books only</strong>. Another form is available to <a href="/id0904f67a801f8f52">request journal articles</a>, <a href="/id0904f67a801f8f4b">entire books</a>, or <a href="/id0904f67a80563c3a">DVD/VHS</a>.</li>
<li>Items in <span style="color:#ff0000;">red</span> are required.</li>
<li>This form accomodates the request of up to five book chapters. Please use as many forms as necessary.</li>
<li>After you send this Reserve Book Chapter Request, an acknowledgment will appear on your Web browser screen.</li>
<li><strong>Fair Use permits one chapter or fifteen percent of a total book, whichever is greater, to be placed on electronic reserves. Requests exceeding this amount will be forwarded to your subject librarian for review before your request is processed.</strong></li>
</ul>
<form action="http://www.library.siue.edu/lib/forms/reschapter.php3" method="post">
<h3 class="bodytitle">Instructor</h3>
<table border="0">
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<th class="bigbodytitle" align="right"><span style="color:#ff0000;">Faculty Name</span>:</th>
<td class="bodytext"><input name="Name" size="30" /></td>
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<th class="bigbodytitle" align="right"><span style="color:#ff0000;">Office Telephone</span>:</th>
<td class="bodytext"><input name="Sphone" maxlength="7" size="7" /></td>
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<th class="bigbodytitle" align="right"><span style="color:#ff0000;">E-Mail Address</span>:</th>
<td class="bodytext"><input name="Email" /></td>
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</tbody>
</table>
<h3 class="bodytitle">Course</h3>
<table border="0">
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<th class="bigbodytitle" align="right"><span style="color:#ff0000;">Course Prefix</span>:</th>
<td class="bodytext"><select name="CoursePref" size="1"><option selected="selected">ACCT</option> <option>AD</option> <option>ADED</option> <option>ANTH</option> <option>ART</option> <option>AS</option> <option>BIOL</option> <option>BSED</option> <option>CE</option> <option>CHEM</option> <option>CHIN</option> <option>CI</option> <option>CIS</option> <option>CIV</option> <option>CJ</option> <option>CMIS</option> <option>CNST</option> <option>CS</option> <option>DANC</option> <option>DS</option> <option>ECE</option> <option>ECON</option> <option>EDAD</option> <option>EDFD</option> <option>EDUC</option> <option>EE</option> <option>ENG</option> <option>ENSC</option> <option>ENVS</option> <option>EPFR</option> <option>ESCI</option> <option>FAC</option> <option>FIN</option> <option>FL</option> <option>FR</option> <option>GBA</option> <option>GEOG</option> <option>GER</option> <option>GRK</option> <option>GRN</option> <option>HE</option> <option>HED</option> <option>HIST</option> <option>HS</option> <option>HUM</option> <option>IE</option> <option>IME</option> <option>IS</option> <option>IT</option> <option>ITAL</option> <option>KIN</option> <option>LAT</option> <option>LIBS</option> <option>MATH</option> <option>MBA</option> <option>MC</option> <option>ME</option> <option>MGMT</option> <option>MKTG</option> <option>MS</option> <option>MSC</option> <option>MUS</option> <option>NURS</option> <option>OR</option> <option>PAPA</option> <option>PE</option> <option>PHAS</option> <option>PHEP</option> <option>PHIL</option> <option>PHPR</option> <option>PHPS</option> <option>PHYS</option> <option>POLS</option> <option>PROD</option> <option>PSYC</option> <option>RUSS</option> <option>SAB</option> <option>SCI</option> <option>SOC</option> <option>SOCW</option> <option>SPAN</option> <option>SPC</option> <option>SPE</option> <option>SPPA</option> <option>STAT</option> <option>THEA</option> <option>UNIV</option> <option>WMST</option> </select></td>
</tr>
<tr>
<th class="bigbodytitle" align="right"><span style="color:#ff0000;">Course Number</span>:</th>
<td class="bodytext"><input name="CourseNo" maxlength="4" size="4" /></td>
</tr>
<tr>
<th class="bigbodytitle" align="right"><span style="color:#ff0000;">Section Number</span>:</th>
<td class="bodytext"><input name="SectionNo" maxlength="6" size="6" /></td>
</tr>
<tr>
<th class="bigbodytitle" align="right"><span style="color:#ff0000;">Academic Term</span>:</th>
<td class="bodytext"><select name="Term"><option>Summer 2012</option> <option>Fall 2012</option> <option>Spring 2013</option> </select></td>
</tr>
<!-- <TR><TH ALIGN=RIGHT><FONT COLOR="#FF0000">Number of Students</FONT>:</TH><TD><INPUT TYPE="TEXT" NAME="StudentNo" SIZE=3 MAXLENGTH=3></TD></TR> -->
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<th align="right"><br /></th>
<td><br /></td>
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<h3 class="bodytitle">Current Reserve Materials</h3>
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<th class="bigbodytitle" align="right">Action to be Taken:</th>
<td class="bodytext"><input name="Special" type="radio" checked="checked" value="New" />New<br /><input name="Special" type="radio" value="Renew" />Renew<br /><input name="Special" type="radio" value="Remove" />Remove<br /></td>
</tr>
</tbody>
</table>
<h3 class="bodytitle">Materials</h3>
<table border="0">
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<tr valign="top">
<th class="bodytitle" align="right">Place Materials On:</th>
<td class="bodytext"><input name="Materials" type="radio" checked="checked" value="Blackboard" />Blackboard<br /><input name="Materials" type="radio" value="Electronic_Reserves" />Electronic Reserves</td>
</tr>
</tbody>
</table>
<h3 class="bodytitle">Book 1</h3>
<table border="0">
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<tr valign="top">
<th class="bigbodytitle" align="right"><span style="color:#ff0000;">Author</span>:</th>
<td class="bodytext"><input name="Author1" size="30" /></td>
</tr>
<tr valign="top">
<th class="bigbodytitle" align="right"><span style="color:#ff0000;">Title</span>:</th>
<td class="bodytext"><input name="Title1" size="30" /></td>
</tr>
<tr valign="top">
<th class="bodytitle" align="right">Publisher:</th>
<td class="bodytext"><input name="Publisher1" /></td>
</tr>
<tr valign="top">
<th class="bodytitle" align="right">Year:</th>
<td class="bodytext"><input name="PubYear1" /></td>
</tr>
<tr valign="top">
<th class="bodytitle" align="right">Edition:</th>
<td class="bodytext"><input name="Edition1" /></td>
</tr>
<tr valign="top">
<th class="bodytitle" align="right">Call number:</th>
<td class="bodytext"><input name="CallNum1" /></td>
</tr>
<tr valign="top">
<th align="right"><span class="bigbodytitle">Chapter Title:</span></th>
<td><input name="ChptrTitle1" size="30" id="ChptrTitle1" /></td>
</tr>
<tr valign="top">
<th align="right"><span class="bigbodytitle"><span style="color:#ff0000;">Chapter Author</span>:</span></th>
<td><input name="ChptrAuthor1" size="30" id="ChptrAuthor1" /></td>
</tr>
<tr valign="top">
<th align="right"><span class="bigbodytitle"><span style="color:#ff0000;">Inclusive Pages</span>:</span></th>
<td><input name="IncPages1" size="30" id="IncPages1" /><br /></td>
</tr>
<tr valign="top">
<th class="bodytitle" align="right">Loan period:</th>
<td><span class="bodytext"><input name="Loan1" type="radio" checked="checked" value="2 hour" />2 hour <em>(item must be used on floor 1, 2, or 3 of the Library)</em><br /><input name="Loan1" type="radio" value="3 hour" />3 hour <em>(item must be used on floor 1, 2, or 3 of the Library)</em></span><br /></td>
</tr>
<tr valign="top">
<th class="bodytitle" align="right"></th>
<td></td>
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</table>
<h3 class="bodytitle">Book 2</h3>
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<th class="bodytitle" align="right">Author:</th>
<td class="bodytext"><input name="Author2" size="30" /></td>
</tr>
<tr valign="top">
<th class="bodytitle" align="right">Title:</th>
<td class="bodytext"><input name="Title2" size="30" /></td>
</tr>
<tr valign="top">
<th class="bodytitle" align="right">Publisher:</th>
<td class="bodytext"><input name="Publisher2" /></td>
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<tr valign="top">
<th class="bodytitle" align="right">Year:</th>
<td class="bodytext"><input name="PubYear2" /></td>
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<tr valign="top">
<th class="bodytitle" align="right">Edition:</th>
<td class="bodytext"><input name="Edition2" /></td>
</tr>
<tr valign="top">
<th class="bodytitle" align="right">Call number:</th>
<td class="bodytext"><input name="CallNum2" /></td>
</tr>
<tr valign="top">
<th align="right"><span class="bodytitle">Chapter Title:</span></th>
<td><input name="ChptrTitle2" size="30" id="ChptrTitle2" /></td>
</tr>
<tr valign="top">
<th align="right"><span class="bodytitle">Chapter Author:</span></th>
<td><input name="ChptrAuthor2" size="30" id="ChptrAuthor2" /></td>
</tr>
<tr valign="top">
<th align="right"><span class="bodytitle">Inclusive Pages:</span><br /></th>
<td><input name="IncPages2" size="30" id="IncPages2" /><br /></td>
</tr>
<tr valign="top">
<th class="bodytitle" align="right">Loan period:</th>
<td><span class="bodytext"><input name="Loan2" type="radio" checked="checked" value="2 hour" />2 hour <em>(item must be used on floor 1, 2, or 3 of the Library)</em><br /><input name="Loan2" type="radio" value="3 hour" />3 hour <em>(item must be used on floor 1, 2, or 3 of the Library)</em></span><br /></td>
</tr>
<tr valign="top">
<th class="bodytitle" align="right"></th>
<td></td>
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</tbody>
</table>
<h3 class="bodytitle">Book 3</h3>
<table border="0">
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<tr valign="top">
<th class="bodytitle" align="right">Author:</th>
<td class="bodytext"><input name="Author3" size="30" /></td>
</tr>
<tr valign="top">
<th class="bodytitle" align="right">Title:</th>
<td class="bodytext"><input name="Title3" size="30" /></td>
</tr>
<tr valign="top">
<th class="bodytitle" align="right">Publisher:</th>
<td class="bodytext"><input name="Publisher3" /></td>
</tr>
<tr valign="top">
<th class="bodytitle" align="right">Year:</th>
<td class="bodytext"><input name="PubYear3" /></td>
</tr>
<tr valign="top">
<th class="bodytitle" align="right">Edition:</th>
<td class="bodytext"><input name="Edition3" /></td>
</tr>
<tr valign="top">
<th class="bodytitle" align="right">Call number:</th>
<td class="bodytext"><input name="CallNum3" /></td>
</tr>
<tr valign="top">
<th align="right"><span class="bodytitle">Chapter Title:</span></th>
<td><input name="ChptrTitle3" size="30" id="ChptrTitle3" /></td>
</tr>
<tr valign="top">
<th align="right"><span class="bodytitle">Chapter Author:</span></th>
<td><input name="ChptrAuthor3" size="30" id="ChptrAuthor3" /></td>
</tr>
<tr valign="top">
<th align="right"><span class="bodytitle">Inclusive Pages:</span><br /></th>
<td><input name="IncPages3" size="30" id="IncPages3" /><br /></td>
</tr>
<tr valign="top">
<th class="bodytitle" align="right">Loan period:</th>
<td><span class="bodytext"><input name="Loan3" type="radio" checked="checked" value="2 hour" />2 hour <em>(item must be used on floor 1, 2, or 3 of the Library)</em><br /><input name="Loan3" type="radio" value="3 hour" />3 hour <em>(item must be used on floor 1, 2, or 3 of the Library)</em></span><br /></td>
</tr>
<tr valign="top">
<th class="bodytitle" align="right"></th>
<td></td>
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</tbody>
</table>
<h3 class="bodytitle">Book 4</h3>
<table border="0">
<tbody>
<tr valign="top">
<th class="bodytitle" align="right">Author:</th>
<td class="bodytext"><input name="Author4" size="30" /></td>
</tr>
<tr valign="top">
<th class="bodytitle" align="right">Title:</th>
<td class="bodytext"><input name="Title4" size="30" /></td>
</tr>
<tr valign="top">
<th class="bodytitle" align="right">Publisher:</th>
<td class="bodytext"><input name="Publisher4" /></td>
</tr>
<tr valign="top">
<th class="bodytitle" align="right">Year:</th>
<td class="bodytext"><input name="PubYear4" /></td>
</tr>
<tr valign="top">
<th class="bodytitle" align="right">Edition:</th>
<td class="bodytext"><input name="Edition4" /></td>
</tr>
<tr valign="top">
<th class="bodytitle" align="right">Call number:</th>
<td class="bodytext"><input name="CallNum4" /></td>
</tr>
<tr valign="top">
<th align="right"><span class="bodytitle">Chapter Title:</span></th>
<td><input name="ChptrTitle4" size="30" id="ChptrTitle4" /></td>
</tr>
<tr valign="top">
<th align="right"><span class="bodytitle">Chapter Author:</span></th>
<td><input name="ChptrAuthor4" size="30" id="ChptrAuthor4" /></td>
</tr>
<tr valign="top">
<th align="right"><span class="bodytitle">Inclusive Pages:</span><br /></th>
<td><input name="IncPages4" size="30" id="IncPages4" /><br /></td>
</tr>
<tr valign="top">
<th class="bodytitle" align="right">Loan period:</th>
<td><span class="bodytext"><input name="Loan4" type="radio" checked="checked" value="2 hour" />2 hour <em>(item must be used on floor 1, 2, or 3 of the Library)</em><br /><input name="Loan4" type="radio" value="3 hour" />3 hour <em>(item must be used on floor 1, 2, or 3 of the Library)</em></span><br /></td>
</tr>
<tr valign="top">
<th class="bodytitle" align="right"></th>
<td></td>
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</tbody>
</table>
<h3 class="bodytitle">Book 5</h3>
<table border="0">
<tbody>
<tr valign="top">
<th class="bodytitle" align="right">Author:</th>
<td class="bodytext"><input name="Author5" size="30" /></td>
</tr>
<tr valign="top">
<th class="bodytitle" align="right">Title:</th>
<td class="bodytext"><input name="Title5" size="30" /></td>
</tr>
<tr valign="top">
<th class="bodytitle" align="right">Publisher:</th>
<td class="bodytext"><input name="Publisher5" /></td>
</tr>
<tr valign="top">
<th class="bodytitle" align="right">Year:</th>
<td class="bodytext"><input name="PubYear5" /></td>
</tr>
<tr valign="top">
<th class="bodytitle" align="right">Edition:</th>
<td class="bodytext"><input name="Edition5" /></td>
</tr>
<tr valign="top">
<th class="bodytitle" align="right">Call number:</th>
<td class="bodytext"><input name="CallNum5" /></td>
</tr>
<tr valign="top">
<th align="right"><span class="bodytitle">Chapter Title:</span></th>
<td><input name="ChptrTitle5" size="30" id="ChptrTitle5" /></td>
</tr>
<tr valign="top">
<th align="right"><span class="bodytitle">Chapter Author:</span></th>
<td><input name="ChptrAuthor5" size="30" id="ChptrAuthor5" /></td>
</tr>
<tr valign="top">
<th align="right"><span class="bodytitle">Inclusive Pages:</span><br /></th>
<td><input name="IncPages5" size="30" id="IncPages5" /><br /></td>
</tr>
<tr valign="top">
<th class="bodytitle" align="right">Loan period:</th>
<td><span class="bodytext"><input name="Loan5" type="radio" checked="checked" value="2 hour" />2 hour <em>(item must be used on floor 1, 2, or 3 of the Library)</em><br /><input name="Loan5" type="radio" value="3 hour" />3 hour <em>(item must be used on floor 1, 2, or 3 of the Library)</em></span><br /></td>
</tr>
<tr valign="top">
<th class="bodytitle" align="right"></th>
<td></td>
</tr>
</tbody>
</table>
<p><input type="submit" value="Send Reserve Book Request" /><input type="reset" value="Clear This Form and Start Over" /></p>
</form>