Application for Library Participation in KICNET

2. Library Name*

4. Address*

5. City*

6. Zip+4*

8. Phone*

9. Fax

11. Interlibrary Loan Librarian*

12. Email*

    Note: This email address will be subscribed to KANILL-L, the Kansas Interlibrary Loan mailing list.

14. Administration Officer*

15. Email*

17. Number of Days per Week ILL Handled*
    -- Select One --34567

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18. 1. Receive an email copy of this form.
19. Email address

    This field is not part of the form submission.

20. Submit

* indicates a required field