Western Libraries

Associated Persons Request Form

An Associated Person is an individual who has a recognized and approved affiliation with Western University but who is not an employee of Western. Associated Persons require access to resources to allow them to fulfill their roles.

This form is to ensure that individuals have an approved affiliation with Western Libraries. By completing and submitting this form, you indicate understanding and agreement of the Obligations and Terms of Access outlined below. Access will begin when HR receives the required information and has established the account. Access will be terminated after one-year unless renewal has been requested via submission of a new form.

Please note: If approved, Human Resource will request the following personal information.

  1. Western Student Number (if one already exists)
  2. Western Employee Number (if one already exists)
  3. Legal Name (first, middle and last)
  4. Birth Date (yyyy/mm/dd)
  5. Gender
  6. Last 4 digits of SIN
  7. Address (address, city, province, country, postal code)

Obligations and Terms of Access

If approved as a Western University Associated Person:

I understand that I have been granted access to databases and full text electronic resources through Western Libraries so that I may act as an intermediary by facilitating access to information and its retrieval for Western University's faculty, staff and students and no others.

I understand that any other use (beyond that described above) of the databases and full text electronic resources constitutes an infringement of current licensing agreements signed by The University of Western Ontario.

I understand that if I misuse this privilege, I will be solely responsible for legal consequences and that my access to these electronic resources will be immediately discontinued.

*

*

  • *
  • Renewal New Request
  • *
  • *
  • *
  • *
  • *
  • *
  • *
  • *
Ignore this field