Helmke Library Special Needs Application 

1. Name of department:
2. Title of proposal:
3. Dollar amount requested (limit $3000 per proposal):
4. Type of need:
1. _____core collection for a new course or program
2. _____periodical backfile (no ongoing subscriptions will be considered.)
3. _____collection deficiency
4. _____maintenance of collection strength
5. _____other. Explain________________________________________
5. Describe how the SPECIAL FUNDS will impact your academic program. (No more than one typed page.) Your comments need to be sufficiently specific in order that the subcommittee can make an informed decision.
6. Complete list of titles requested. Lists must be typed and must be prioritized. See guidelines for further details.

Name of person submitting request ______________________________

Department chair _______________________________________________

Librarian who is liaison to the department ________________________

Date of request ________________