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Please note: ILL service is only available to registered Burlington County Library cardholders who have no overdue ILL material and who owe less than $10.00 in outstanding charges.
Item to be Requested
Journal Title:
Series: ISSN:
Volume and Issue:
Page Numbers: Issue Date:
Article Author:
Article Title:
If necessary, would you
pay more than the $1
charge for this service?		 Yes
No
Pickup location:
Source of your
information,
or comments:
Last date you will
accept this item: 		// (mm/dd/yyyy)
Customer Information
Patron Name:
Library Card
Number:
PIN:
Telephone
Number:
Select One: Adult
Youth/Child
Staff
Other
Customer Address:
When finished filling out
both sections of this form,
please click here:
Note: Items in red must be entered.
Burlington County Library System | 5 Pioneer Boulevard | Westampton, NJ 08060
Phone: (609) 267-9660 | Fax: (609) 267-4091