Register for Borrowing Privileges

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You may use this form to apply for borrowing privileges at Scott Memorial:

Complete the form online
Print the completed form
Deliver the form in person (with your photo ID) to the 2nd floor Circulation Window of Scott Memorial Library, OR
Mail the form and a photocopy of your ID to Access Services, Scott Memorial Library, 1020 Walnut Street, Philadelphia, PA 19107.

Fields marked with asterisks (*) are required.

Print this completed form and bring it, along with your photo ID, to the 2nd floor Circulation Window in the Scott Building.

Name: *
Jefferson Campus Key (Jeffersonians only):
Jefferson ID Badge Barcode (Jeffersonians only):	(from the back of your photo ID, visitor's ID, or alumni card)
TJU Email Address:
Work/Campus Contact Information:
Phone #: *
Building, Suite: *
Street: *
City, State, Zip: *
Home Contact Information:
Phone #: *
Building, Suite: *
Street: *
City, State, Zip: *
Your Role at Jefferson *
Your Jefferson School or Employer:	OR Your Affiliated Institution:
	OR
Please check all that apply: *	Alumna/Alumnus Employee - Jefferson Employee - JMC Affiliate Position Title Faculty: Department Paid by Jefferson Volunteer, JMC Volunteer, Other Jefferson Programs Emeritus Fellow Post-Doctoral Fellow Resident Student - Jefferson Expected graduation date Student - Visiting / Rotation / Short-term Sponsoring department or contact: Home institution: Date visit ends: Jefferson Hospital Volunteer