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Remote Access to Electronic Databases Agreement
(designed to be printed)
Please print clearly!
Last Name: ____________________________________________________
First Name: _________________________________ Middle Initial: ____
Please circle one: student faculty/staff adjunct faculty
Department: (for faculty & staff only) _______________________________
E-mail Address: _________________________________________________
Your application will be delayed if we cannot read your email address.
Telephone Number: _____________________________________________
Fax Number: (if available) _________________________________________
By signing on the line below, you are agreeing:
- to safeguard the security of your password
- not to share the access information you have been given with anyone!
- that you are a currently enrolled student, faculty or staff of MCCC
- that you agree to abide by all federal, state and local copyright laws
Signed: ___________________________________________
(signature of the person above)
Date: ____________________________
Unsigned agreements will not be processed and will be discarded. Your account will remain active only during the semesters in which you are enrolled. Please reapply if you have not been enrolled for 3 consecutive semesters.
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Mail to:
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Fax to:
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Submit in Person:
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Return via MCCC Interdepartmental Mail:
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Mercer County Community College Library
Attn: Library Secretary
P.O. Box B
Trenton, NJ 08690
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(609) 570-3845
Attn: Library Secretary
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Drop off form at the Circulation Desk of the West Windsor or JKC Library
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Library Secretary
Room LB 104
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