LIBRARY ACCOUNT APPLICATION
Date: Your Name:
(Last) (First)
Address: Bldg.: Rm.: Telephone:
Email Address:
PIV Card No:
Library Barcode: 2 0 5 4 9 0 0 0 0 (to be completed by library staff)
Program:
(DMS, LEIDOS, NCI) (Please include name of laboratory)
Supervisor’s Name:
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Email completed form to NCIFredLibrary@mail.nih.gov
Borrowers assume total responsibility for any material borrowed from the Library, being held personally accountable for its loss or damage.
Should a book be damaged or lost when it is checked out, it is the responsibility of the borrower (or their designated representative who picked up
the book) to reimburse the Scientific Library for its replacement cost. In the event that the borrower terminates employment at NCI-F and said
costs have not been recovered, the funds will be withheld from the final paycheck.
The Scientific Library subscribes to certain electronic titles according to license terms that permit use by NCI-F’s authorized users for
educational and scholarly/research purposes, as allowed by use of the patron account. Patrons who request an account assume responsibility for
respecting the copyright of owners as well as any user restrictions that may be identified as they visit these resources. NCI-F users are advised
to read the Notice of Copyright/Use Restrictions for Electronic Resources Purchased by the NCI-F Scientific Library, posted on the Librarys
website on the Policies page. The Library reserves the right to terminate off-site use of Library online resources should any unauthorized use
be discovered, including sharing of privileges with non-authorized individuals.
Your signature on this form serves as acceptance of these terms of use.
FOR STAFF USE: (Please sign and date.)
Application received by
Record entered in system by
Proofed by
Signature
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ITEM(S) CHECKED OUT
1.
Call No.:
Title:
Book Barcode:
3 0 5 4 9 Due Date:
2.
Call No.:
Title:
Book Barcode:
3 0 5 4 9 Due Date:
Rev. 5/27/21
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