This form may be used by faculty and academic staff to register a student or staff member to check library materials out in your name.
This is not a submittable online form—it must be printed on UW-Stout or departmental letterhead to verify its authenticity and include your signature for authorization.
The names on this form can be changed at anytime, as can the expiration dates. To ADD proxies, simply send a new signed authorization. To REMOVE an authorization, call the Circulation Desk at 715/232-1215 or email.