Authorized (Proxy) User Request

Forms

Authorized (Proxy) User Request

This form allows a patron to designate a specific person to use their library account to check out materials. This form should be completed by the primary patron. **Fields in bold are required. This form requires two business days to be processed.

** Full name: *

Primary Patron Information

** Library ID number: *

Indicated by "LIB#" on the front bottom portion of your Cardinal Card

** Expiration date: *

The Individual listed below will be a fully authorized user on your UofL library account. They will be able to charge materials from the University Libraries in your name through this date. By filling out this form, you, the primary patron, accept 100% fiscal responsibility for the charges this authorized user will make to your library account.

Department:

Phone:

Email: *

Campus address:

**Authorized User's name: *

Authorized Users must be at least 18 years of age and have a UofL Library account in good standing.

**Authorized User's library ID number: *

Indicated by "LIB#" on the front bottom portion of Authorized User's Cardinal Card or the "4556..." number on the back of their red UofL Community Borrowers Card.

CAPTCHA

This question is for testing whether you are a human visitor and to prevent automated spam submissions.

Math question: * eight + = fifteen

Solve this math question and enter the solution with digits. E.g. for "two plus four = ?" enter "6".