Millikin University - Decatur, IL
Proxy Borrowing Form (for Teaching/Departmental Assistants)

On a restricted basis, Millikin University faculty members and administrators may designate another Millikin University person such as a teaching or departmental assistant to borrow library materials on the faculty member’s or administrator’s behalf (proxy borrowing). They may also place items on and remove items from reserve on the faculty member's or administrator's behalf.

Since materials thus borrowed become the responsibility of the person on whose behalf they are borrowed, a written authorization form is required as protection for the faculty member or administrator. No proxy borrowing permission will be granted without this signed permission form.

The library’s circulation system will be set up so that the proxy (assistant) borrower will use their own Millikin University ID to charge library items to the faculty member's or administrator's library account, for the time period indicated on this form.

I authorize the person named below (proxy borrower) to borrow Staley Library materials on my behalf:

Name of proxy borrower: _________________________________________

MU ID # of proxy borrower:

Length of time for which this authorization is valid (one school year maximum):

From:      201_      to          201_    

OR:     (name of semester) ______________________

I acknowledge that I am fully responsible for any materials borrowed by my proxy.

Name of faculty member/administrator: __________________________________

MU ID # of faculty member/administrator: ________________________________

Signature of faculty member/administrator: ______________________________

Name of library staff member accepting authorization: ___________________________

Today’s date:               201_    

Millikin University - Decatur, IL
Millikin University - Decatur, IL