View entry
Verifying access...
Entry #32775
Proxy Request
Submitted: 2025-01-03 20:14:09
Form Fields
Your Name
ID: 8
First: Isabelle
Last: Goodheart
Your vNumber
ID: 5
00385003
Email
ID: 17
Email address of person you are authorizing to check items out
ID: 7
vNumber of the person you are authorizing (if applicable)
ID: 11
00385118
Name of the person you are authorizing
ID: 9
First: Juan
Last: Mendoza
When should the authorization should expire?
ID: 12
01/31/2025
Consent
ID: 14
Consent: 1
Text: I understand and agree to the above
Description: 8