Registration for Francis A. Drexel Library Services to DE Pharmaceutical EMBA Students

Registration Form
To help us serve you better, kindly complete and submit this form.

Name:
Preferred Email Address:
Home Address:
Home Phone Number:
Home Fax Number:
Home Internet Service Provider: (e.g. AOL)
Do you anticipate accessing our Library's electronic resources from your workplace?	Yes No
Corporate Affiliation:
Work Phone Number:
Work Fax Number:
For this program, do you have access to resources in your corporate library?	Yes No
Name and city of your local public library:
Names of the colleges/universities from which you have graduated:

Please note: by sending this e-mail, the sender agrees to the following:

I authorize the staff of the Francis A. Drexel Library to check out materials to me upon my request, using the 16-digit number on the front of my SJU HawkCard. I accept responsibility for those materials which are checked out and sent to me. I understand that the responsibility starts at the time I receive the materials and ends when they are returned to the Francis A. Drexel Library. I agree to pay fines for overdue, damaged or lost materials checked out in my name.