Authorize a Check Out Agent

A check out agent is authorized to check out materials in another person's name. Fill out this form if you would like to authorize a check out agent. Please note that you are responsible for material checked out by your agent, including charges for lost or damaged material. Your check out agent will have full access to your library record. You can rescind a check out agent's authorization at any time by calling the Information Center at (406)243-6866 or emailing library.circ@umontana.edu.

Your Information

Materials will be checked out in this person's name.

Name *

Email Address *

790- or Montana Borrower ID *

Check Out Agent Information

Insert the information of the person checking out materials in your name. A check out agent must have or must establish a library account and must bring a photo ID to check out items.

Check Out Agent Name *

Authorization Expiration Date

Month

Day

Year

I authorize the above check out agent to check out library material in my name. I understand that I will be responsible for all material checked out by my agent, including any charges for lost or damaged material. Submitting this form acts as a signature in agreement with these terms.

* indicates a required field

Mansfield Library

Library Services Section Sidebar Navigation

Authorize a Check Out Agent

Your Information

Check Out Agent Information