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Faculty Proxy Agreement

A proxy form is required when library material is borrowed in the name of a faculty member by an authorized representative.  This information will be kept by the University Library and automatically cancelled at the end of the semester, unless a date is specified below.

Library policy defines a proxy as one of the following:

  • SSU Faculty spouse
  • SSU staff member
  • SSU graduate student
  • SSU enrolled student working or a faculty member

By submitting the form you understand that all items are borrowed in your name, including overdue fines and bills for lost and damaged materials. 

Proxy Borrower request

Optional - Specify a date when the proxy should end. If left blank, the proxy will be automatically cancelled at the end of the semester.