Electronic Course Reserves Form (Blackboard)

About You

Name (Required)

University ID number: (Required)

Seven digit number

E-Mail Address (Required)

Phone:

Department:

Campus address:

Initial to indicate you accept the following conditions (Required)

"I attest that all submitted materials (a) do not currently appear in any course-pak, (b) comply with current course and electronic reserve policies, and (c) comply with current U.S. copyright law. No reserve will be completed unless this form is signed by the designated faculty member above." [Copyright Checklist]

Course Information

Course number:

ex. PSYC 542-01

Course name:

Semester & Year:

Item 1

Item type:

Select one... Book section Journal article Notes, homework, exams, etc. (photocopy) Other (describe in comments field)

Item owned by:

All course reserves must follow copyright rules. The University Libraries will not be responsible for any loss or damage.

Instructor's personal copy (if book chapter)
Photocopy
Library copy (indicate call number)

Call Number:

Journal Title or Book Title:

Article Title or Chapter Title:

Author:

Year:

Volume Number:

Issue Number:

Pages:

(Ex. pages 210-219)

Instructor's Comments:

Item 2

Item type:

Select one... Book section Journal article Notes, homework, exams, etc. (photocopy) Other (describe in comments field)

Item owned by:

All course reserves must follow copyright rules. The University Libraries will not be responsible for any loss or damage.

Instructor's personal copy (if book chapter)
Photocopy
Library copy (indicate call number)

Call Number:

Journal Title or Book Title:

Article Title or Chapter Title:

Author:

Year:

Volume Number:

Issue Number:

Pages:

(Ex. pages 210-219)

Instructor's Comments:

Item 3

Item type:

Select one... Book section Journal article Notes, homework, exams, etc. (photocopy) Other (describe in comments field)

Item owned by:

All course reserves must follow copyright rules. The University Libraries will not be responsible for any loss or damage.

Instructor's personal copy (if book chapter)
Photocopy
Library copy (indicate call number)

Call Number:

Journal Title or Book Title:

Article Title or Chapter Title:

Author:

Year:

Volume Number:

Issue Number:

Pages:

(Ex. pages 210-219)

Instructor's Comments:

Item 4

Item type:

Select one... Book section Journal article Notes, homework, exams, etc. (photocopy) Other (describe in comments field)

Item owned by:

All course reserves must follow copyright rules. The University Libraries will not be responsible for any loss or damage.

Instructor's personal copy (if book chapter)
Photocopy
Library copy (indicate call number)

Call Number:

Journal Title or Book Title:

Article Title or Chapter Title:

Author:

Year:

Volume Number:

Issue Number:

Pages:

(Ex. pages 210-219)

Instructor's Comments:

Item 5

Item type:

Select one... Book section Journal article Notes, homework, exams, etc. (photocopy) Other (describe in comments field)

Item owned by:

All course reserves must follow copyright rules. The University Libraries will not be responsible for any loss or damage.

Instructor's personal copy (if book chapter)
Photocopy
Library copy (indicate call number)

Call Number:

Journal Title or Book Title:

Article Title or Chapter Title:

Author:

Year:

Volume Number:

Issue Number:

Pages:

(Ex. pages 210-219)

Instructor's Comments: