Audio/Visual Request Form
Updated: 11/10/2003
Name
__________________________________________________________
Last
First
(initial)
E-Mail
Address ___________________________________________
Telephone
Number _____________________________
Organization
_____________________________________________
Ground
Shipping Address ___________________________________
(FedEx or UPS - No POB Accepted)
_______________________________________________________
_______________________________________________________
Street
Address (if different from mailing address - for UPS and FedEx)
_______________________________________________________
_______________________________________________________
City
State
Use a
separate sheet for each month's request
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Number |
Title |
Date Desired |
Alternate
Date |
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Mail
to:
ORA Lending Library
Division of Human Resource Development
Food and Drug Administration
5600 Fishers Lane, HFC-60
Rockville, Maryland 20857 |
I
have read the policies and procedures for borrowing training materials from the DHRD
Library. I agree to all the terms and conditions therein. ____________________________
signature |
Fax to: Lending Library
301-827-8708 |
Back to Library
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