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Application for Unassisted Access to D. H. Hill Library

For the MS Word document version, download and return the form to: NCSU Libraries Administrative Office, Campus Box 7111, Raleigh, NC 27695-7111.
(919) 515-7188
Rules on Unassisted Access to D. H. Hill Library (Hillsborough Street Door)
More information on Accessibility services - http://www.lib.ncsu.edu/disabilityservices

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Name *

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Date of Application *

Year

Month

Day

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Employee/Student *

Employee

Student

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University ID No. *

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Campus Parking Permit No.

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Campus Department

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Home Address *

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Campus Box

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Home Phone

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Campus Phone

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Do you have a Handicapped Parking Permit? *

Yes

No

If "No", have physician fill out Section II of the printed form.