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Web Database Recommendation Form
Date of Request:		Name of Requestor:	-----Select One----- Bob Carolyn Frank Lori Vicki Technical Services
Title:
Vendor:
Identified:
	Vendor	If identified by vendor, Vendor Contact:
	Name:
	Role:
	Address:
	Phone:
	Email:
	Faculty Request:
	Name:
	Department:
	Student Request:
	Name:
	Degree/Major:
	Librarian:	-----Select One----- Bob Carolyn Frank Lori Vicki Technical Services
	Other:
Anticipated use: (e.g. How does the material support the curriculum? What subject areas are covered? Does the content fill a significant need or replace information currently obtained in other formats?)
If the vendor has already been contacted please complete each field below and submit the form. Otherwise, submit the form as is and Technical Services will contact the vendor for this information.
Database URL:
Information URL:
Format of Database:	(full-text, index, etc.)
Coverage Dates:
Total number titles:
Annual cost:
Questions to ask prior to trial:
Authentication:	Select One IP Addresses Username/Password
	If Username/Password, can the password be shared?   Yes   No
Proxy allowed?	Yes   No
OpenURL compliant?	Yes   No
Multiple-site Usage?	Yes   No
Unlimited Usage?	Yes   No
	If no, prices for ranges of concurrent users (i.e., 1-3 users, 1-5 users; etc.):
Sole source letter?	Yes   No
Administrative module?	Yes   No
Branding?	Yes   No
Tutorials?	Yes   No
Help screens?	Yes   No
If yes, provide url:
Vendor supplied training?	Yes   No
Persistent URLs?	Yes   No
Usage statistics?	Yes   No
If yes, COUNTER-compliant?		Yes   No
Marketing programs/materials?	Yes   No
If yes, provide url:
Special Requirements?
Additional Information:
Trial Recommended?	Yes   No
	If yes, Trial initiated by:	-----Select One----- Bob Carolyn Frank Lori Vicki Technical Services
	Trial url:
	Trial dates (MM/DD/YYYY):	Start Date:	End Date:
	Trial description (text or link to text):
	Trial authentication method:  Select One IP Addresses Username/Password
	Trial group:	Library Staff
		Faculty
		Students
		Unlimited
	Person responsible for notifying trial group:  -----Select One----- Bob Carolyn Frank Lori Vicki