UGA LAW LIBRARY PATRON INFORMATION
Note: Use this form only if you are a member of the UGA community.
Non-Alum Attorneys please complete the “Attorney Information Form”
DATE_______________________
Last Name___________________________ First Name _______________ M.I._______
UGA Law School Affiliation:
UGA but Non-Law School Affiliation:
_____Law Student (Select: 1L 2L 3L)
_____UGA Undergraduate Student
P-type=005; Expiration date=8/1/(yr of graduation)
_____Law Student (LLM)
P-type=006; Expiration date=Sept. 1 of next year
_____Law Faculty
P-type=000; No expiration date
_____Law Faculty: visit/adjunct
P-type=001; Expiration=end of semester
_____Law Alum (Class of _______)
P-type=200; No expiration date
_____Law School Staff
P-type=004; No expiration date
P-type=105; Expiration date= the next June 1
_____UGA Graduate Student (non-law)
P-type=106; Expiration date= the next June 1
_____UGA Faculty (non-law)
P-type=100; No expiration date
_____UGA Staff (non-law)
P-type=104; No expiration date
_____UGA Fac/Staff/Student Dependent
P-type=107; Expiration date=one year from application
NOTE: Must present proof of claimed relationship (e.g.,
the sponsor’s ID, which should be entered into the
Dependent’s patron record in Note field
E-mail address [z] ____________________________________________
This is our means of communicating with law library patrons. Overdue notices, fines and bills will
be sent via e-mail only. Students MUST use their UGA e-mail.
Address 1 [a] (If a student, this is your local address; if faculty or staff, this is your campus address; if
alum, this is your home address.)
______________________________________________________________________
______________________________________________________________________
Address 2 [h] (If a student, this is your home address; if faculty or staff, this is your home address; if
alum, this is your work address.)
______________________________________________________________________
______________________________________________________________________
Telephone 1 [t] (If a student, this is your local number; if faculty or staff, this is your campus number;
if alum, this is your home phone.) _____  _____  _________
Telephone 2 [p] (If student, this is your permanent number; if faculty or staff, this is your home
number; if alum, this is your work phone.) _____  _____  _______
STAFF USE ONLY:
Eligibility verified [Yes/No]______________________ Circ Worker accepting this form: ____________
Verify alumni in Alumni directory/database; verify all others only using “Patron Verify” icon on computer terminal
Barcode assigned: _________________________________
This field necessary only if collecting information for later input
PUT COMPLETED FORM IN CIRCULATION MANAGER’S MAILBOX
Rev. 7/2007