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UMass Libraries > Library Services > UMass Amherst Libraries

Application for a Library Proxy Card


(For UMass Faculty, Staff & Special Needs Students Only)

New    Renewal

*Last Name: First Name:
Email:
*Campus Address:
*Campus Phone:
*Library Bar Code #: (15 digit # on staff ID)

*Proxy Name: From: To:  (Month/Year)

All current UMass faculty, staff, & special needs students are eligible for a proxy card. A proxy card allows a designated individual to check out books for the faculty, staff or special needs student .

Personal Agreement: I agree that I will be responsible for all materials charged out on the proxy card and I will respond to all correspondence concerning charges on this card (e.g. overdue notices).

* I have read and agree to the Personal Agreement.

Proxy must present their photo ID when picking up the Proxy Card

*Please select a pick-up location:
    

Lost or stolen cards should be reported immediately.

* Required Fields

 

 

University of Massachusetts Amherst
Amherst, MA 01003-9275
(413) 545-0150  |  Comments?