ILLiad Faculty Proxy Account Request

This form allows you to create an account for graduate/teaching assistants to place requests on your behalf. You will be responsible for materials borrowed through this account. After your request has been processed, you will receive an email with the account's user name and password for you to distribute at your discretion.

First Name

Last Name

Primary Email

Secondary Email

Mailing Address

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Daytime Phone

Department

Authorized Users