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Entry #44807
Proxy Request
Submitted: 2025-08-11 16:08:33
Form Fields
Your Name
ID: 8
First: emily
Last: stanfield
Your vNumber
ID: 5
V00379645
Email
ID: 17
Email address of person you are authorizing to check items out
ID: 7
Name of the person you are authorizing
ID: 9
First: jack
Last: stanfield
When should the authorization should expire?
ID: 12
08/12/2025
Consent
ID: 14
Consent: 1
Text: I understand and agree to the above
Description: 8