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Journal Purchase Request

Please fill out information as completely as possible.

Note: Submit one title only per request. This form relates only to requests for purchase; it is NOT to be used for Interlibrary Loans.

Journal Information

Title	Publisher/Distributor
ISSN
Preferred format * Print Electronic Either
If a specific format is strongly preferred, please explain in Comments.
Comments

Contact Information

Requested by *	Workplace/Department
Phone or Pager *	Email
Prefer to be notified when the journal subscription is activated Yes No

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