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Archives/Special Collections: Patron Registration Form

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Administrative Responsibility | Collection Policy | Deed of Gift Form (PDF)| Deed of Gift Form (electronic) | Disposal of Materials | Exhibition Guidelines | History | Patron Registration Form | Patron Use Guidelines | Reproduction & Publishing Guidelines | Request Form to Publish/Exhibit/Display Materials | Request Form to Reproduce Materials | Use of Materials | Archives Home


Use this request form to obtain permission to use Xavier University library archives or special collections.

Please read the Xavier University archives & special collections Patron Use Guidelines before completing this form.

Name:
Email:
Re-enter Email:
Address:
Home Phone: (123) 456-7890
Work Phone: (123) 456-7890
Date:
Status:

 

Please indicate your affiliation status from the selections below.

XU Undergraduate Student
XU Graduate Student
XU Faculty or Staff Member
XU Alumnus
Other

Intended Use of Materials:

 
Guidelines:

I have been provided with a copy of Xavier University archives & special collections Patron Use Guidelines. I have read these guidelines, understand them and agree to follow them.

Yes:     No:

Last updated: June 18, 2009 3:00 PM

 

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