New Network Membership Application
2006-2011 Middle Atlantic Region

Please fill in the fields below.  Please note, all fields are required.
What level of membership are you applying for?

Full Member 
Affiliate Member

This level of membership is open to any health sciences library or health related information center that:

1. Is regularly staffed.
2. Has an Internet connection.
3. Has its own collection of health sciences materials such as biomedical journals (25 minimum in collection), books, audiovisuals, and/or electronic databases).
4. Provides information services, including collection sharing through the DOCLINE* system and providing information services to health professionals and/or the general public (e.g. answering or referring reference questions and performing information searches).
5. Members are encouraged to provide Loansome Doc service to their users and/or to unaffiliated users.

*Reciprocal borrowing though the DOCLINE system is a key responsibility for Members. Members are required to fill loan requests within two to three business days.

Network Affiliate Member Requirements and Responsibilities
This level of membership is open to libraries or information resource centers that are called upon for health information by their users, but which do not meet all the criteria for Full Member participation. An Affiliate Member might form a cooperative relationship with a Member, for example, for reference assistance or document delivery.

Please fill-in the following institution information.

Library Name:

Institution Name:

Mailing Address:

City: State: Zip:

Contact Person:

e-mail:

Phone:

After submitting this form, you will be contacted by a staff member at the Middle Atlantic Regional Medical Library. 
If you have any question regarding this form, please contact the Middle Atlantic Regional Medical Library at (800) 338-7657.