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University of Connecticut Health Center Library
Patron Registration Email
for
Community Faculty

Our email addreass is circ@nso.uchc.edu. Please include the following information:

Patron Name:

UCHC Department Affiliation Information

UCHC Department: *

UCHC Department Phone Extension:

Contact Person in Department: *

(This person will be contacted to verify your position at UCHC as a community faculty member.)


Work Information

Practice Name:

Street Address:

City:

State:

ZIP code:

Work Phone No.: *

Work E-mail Address:


Residence Information

Street Address: *

Apt. No.

City: *

State: *

ZIP code: *

Home Phone No. : *

Home E-mail Address:

The fields with "*" are required fields.

The information required in this application is necessary in order to comply with electronic database licensing requirements and to limit library borrowing privileges to those who are part of the UCHC community.


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Copyright 1998 - 2006. All Rights Reserved.
Lyman Maynard Stowe Library at the University of Connecticut Health Center
263 Farmington Ave. P.O. Box 4003
Farmington, Connecticut 06034-4003
The URL for this page is: http://library.uchc.edu/proxy/emailcfregistration.html
Last Updated: March 4, 2014