Student Access Request Form

1. Name *

First

Last

2. Email *

3. Is your access for a class? *

Yes
No
Other

If you chose "other," please specify

4. Course Name and Number *

Example: CEAS 320 Media and Literature in China

5. Faculty Supervisor *

6. Requested Objects *

This can either be specific or general. For example, you can request the "Noh Doll" or "objects relating to notions of femininity in the 20th century."

7. Dates Requested *

MM/DD/YYYY

8. What is the purpose of your visit? *

9. Additional Notes/Comment/Questions

Name