Registration Form

In order to receive Rod Library's extra document delivery services, you must first register with Rod Library as a distance user. To do this, simply complete the following Registration Form.

You should register only if your place of residence is outside the greater Cedar Falls/Waterloo metropolitan area [1]. All currently enrolled UNI students are able to access Rod Library's licensed databases from off campus [2].

Please include the following information (* indicates required information):

First Name: *

Last Name: *

University ID Number: *

(Enter your 9 digit university identification number (000######) located on the front of your university ID card. Distance Learners receive a UNI ID card from the UNI Division of Continuing Education and Special Programs with their ID number printed on the front of the card. Guided Independent Study students receive a letter with their university ID number.)

Email Address: *

Retype Email Address: *

Street Address: *

City: *

State: *

Zip Code: *

Home Phone Number:

Work Phone Number:

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Class Status:

Graduate Student - Enrolled

Graduate Student - Non-Enrolled

Undergraduate Student

Course Number: *

Course Name: *

Are you a Guided Independent Study student (GIS)?:

Yes

Authorized Semester:

Spring 2013

Summer 2013

Fall 2013

By submitting this form, you agree to the following:

I authorize the staff of the Rod Library to check out materials to me upon my request. I agree to accept responsibility for those materials which are checked out and sent to me. I understand that responsibility extends from the time I receive the materials until they are once again received by Rod Library.

General Comments:

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