Brandeis University Libraries - Proxy Borrowing Request
Eligible proxies must be current members of the Brandeis community and possess a valid Brandeis ID.  Proxy privileges may be issued for any length of time up to one year (renewable annually upon request). This form must be completed by the requesting faculty member or administrator.  Please allow 2 business days for processing.  
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Request Type: *
Faculty or Administrator's Name: *
Faculty or Administrator's Department: *
Faculty or Administrator's  Email: *
Proxy's Name: *
Proxy's Email: *
Expiration Date: (Proxy privileges will expire on May 15th of each year unless otherwise noted here)
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I authorize the above designee to borrow materials in my name.  I understand that by granting permission to the above designee, I am still responsible for all materials checked out in my name.  *
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