Distance Learner Library Registration Form

We ask that you fill out this form, so that when you request materials from us, we can verify your status as a Distance Learning Student enrolled in a SUNY Learning Network (SLN) online course.

Please allow us 24 hours (excluding weekends and college break periods) to process your registration request.

THE FOLLOWING INFORMATION MUST BE COMPLETED EACH SEMESTER TO APPLY FOR SERVICES

  • All fields marked with an asterisk * are required fields and must be completed.
  • Please enter your personal information below. Press the TAB key to advance through the fields. When finished, click on the "Submit Form" button at the bottom of the page.

Date: *

First Name: *

Last Name: *

Address (Street/Apt.): *

City, State, Zip Code: *

Home Telephone: * (with area code)

Other Telephone: (with area code)

MCC ID #: * (Please enter your assigned Banner M number which serves as your MCC ID #)

MCC Student E-mail Address: * (For example:  jdoe001@student.monroecc.edu)

For information on your MCC Student E-mail Account, visit the MCC Student E-mail page.

List Distance Learning Course Name(s), Number(s) and Section(s) enrolled in: *

(For example: Basic Consumer Nutrition: SLN BIO-117-SL1)

Are you working towards a degree?

If yes, please give anticipated date of completion:

Comments:

BY SUBMITTING THIS FORM, YOU AGREE TO THE FOLLOWING:

I authorize the staff of MCC Libraries to check out materials to me upon my request.

  • I agree to accept responsibility for those materials which are checked out and sent to me.
  • I understand that responsibility extends from the time the materials are shipped until they are once again received by MCC Libraries.
  • This authorization will be in effect for the current academic semester.

Thank you!

  
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