Withdrawal Form

Date: ____/_____/____


  Attention:

	Cataloging   _____
	Serials      _____

  Requested by: 



  Approved by:



  Withdrawn as:		

	Damaged      _____
	Not Wanted   _____


  Withdrawal Disposition:

	Discard      _____

	Other:


  Call Number:  ___________________

          _________________________

          _________________________

          _________________________
   

Short Title:  ____________________

        __________________________

Withdrawal Form

Date: ____/_____/____


  Attention:

	Cataloging   _____
	Serials      _____

  Requested by: 



  Approved by:



  Withdrawn as:		

	Damaged      _____
	Not Wanted   _____


  Withdrawal Disposition:

	Discard      _____

	Other:


  Call Number:  ___________________

          _________________________

          _________________________

          _________________________
   

Short Title:  ____________________

        __________________________