112 · SPEC Kit 296
Kent State University
REGISTRATION FORM
Department of Special Collections and Archives
Kent State University Libraries and Media Services
The information obtained on this form is stored on a secure internal server and is accessible to authorized departmental
personnel only. Paper forms are shredded confidentially following data input. Usage records for Special Collections and
Archives are protected by the same confidentiality policies covering other patron records in Libraries and Media Services.
DATE: _______________________________________
NAME: ________________________________________________________________________________________
(Last, First, Middle)
ADDRESS: _____________________________________________________________________________________
(Street) (Apt. #)
______________________________________________________________________________________
(City, State, Zip Code)
EMAIL (optional): _______________________________________________________________________________
What is your academic affiliation? (check one ONLY)
___Kent State University ___None ___Other -Institution Name: ______________________________
What is your current academic status? (check one ONLY)
___High school ___Undergraduate – JUNIOR ___Graduate – MASTER’S
___Undergraduate – FRESHMAN ___Undergraduate – SENIOR ___Graduate – DOCTORAL
___Undergraduate – SOPHOMORE ___Faculty ___Alumnus
What is your academic major/department? _______________________________________________
The mission of the Department of Special Collections is to build and administer specialized subject collections.
The collections often consist of unique, rare, and fragile items that require careful use if they are to be preserved
for future use.
Reading Room Policies:
1. All users of Special Collections and Archives materials must provide a valid photo ID.
2. Researchers must register with the Department on an annual basis.
3. Special Collections materials may not be checked out and must be used in the reading room.
4. To help preserve the collections, no pens are allowed. Pencils and a pencil sharpener are available.
5. Photocopying is done by staff, only if condition of materials will not be harmed, at $.10 per page.
6. Eating, drinking, and smoking are not permitted in the reading room.
7. Use of cell phones in the reading room is prohibited. Cell phones may be used in the hallway outside of
the reading room area.
8. Bags, backpacks, purses, and coats must be stored on the coat rack near the Reference Desk.
Kent State University
REGISTRATION FORM
Department of Special Collections and Archives
Kent State University Libraries and Media Services
The information obtained on this form is stored on a secure internal server and is accessible to authorized departmental
personnel only. Paper forms are shredded confidentially following data input. Usage records for Special Collections and
Archives are protected by the same confidentiality policies covering other patron records in Libraries and Media Services.
DATE: _______________________________________
NAME: ________________________________________________________________________________________
(Last, First, Middle)
ADDRESS: _____________________________________________________________________________________
(Street) (Apt. #)
______________________________________________________________________________________
(City, State, Zip Code)
EMAIL (optional): _______________________________________________________________________________
What is your academic affiliation? (check one ONLY)
___Kent State University ___None ___Other -Institution Name: ______________________________
What is your current academic status? (check one ONLY)
___High school ___Undergraduate – JUNIOR ___Graduate – MASTER’S
___Undergraduate – FRESHMAN ___Undergraduate – SENIOR ___Graduate – DOCTORAL
___Undergraduate – SOPHOMORE ___Faculty ___Alumnus
What is your academic major/department? _______________________________________________
The mission of the Department of Special Collections is to build and administer specialized subject collections.
The collections often consist of unique, rare, and fragile items that require careful use if they are to be preserved
for future use.
Reading Room Policies:
1. All users of Special Collections and Archives materials must provide a valid photo ID.
2. Researchers must register with the Department on an annual basis.
3. Special Collections materials may not be checked out and must be used in the reading room.
4. To help preserve the collections, no pens are allowed. Pencils and a pencil sharpener are available.
5. Photocopying is done by staff, only if condition of materials will not be harmed, at $.10 per page.
6. Eating, drinking, and smoking are not permitted in the reading room.
7. Use of cell phones in the reading room is prohibited. Cell phones may be used in the hallway outside of
the reading room area.
8. Bags, backpacks, purses, and coats must be stored on the coat rack near the Reference Desk.
