Book Club Kits for Kids - Request Form
 
Please submit the following information to request a Book Club Kit for Kids:
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1. Patron Name:

*

2. Library Card Number:

*

3. Telephone Number:

*

4. E-mail Address (This will be our primary means of communicating with you):

*

5. School/Book Club Name:

*

6. What book do you wish to request? Please tell us your First Title Choice:

 Choose a Title
First Title Choice
*

7. In case your first title choice is unavailable, please give us an Alternative Title:

 Choose Alternative Title
Alternative Title:
*

8. How many books do you think you'll need (maximum 14)?

 Number of Copies
Please choose:
*

9. Library pick up location?

*

10. Number of weeks Kit needed (maximum 9):

 Weeks Needed
Please choose 4-9:
*

11. Would you like a discussion guide sent to you via e-mail? (Guides only available through e-mail in PDF format.)

12. Audio and/or Large Print (available for some titles; check Audio and/or Large Print to request the special format):

13. Please recommend titles you would like us to consider for future kits and any suggestions you have for how we might improve this service.

14. For staff use; please leave blank.
Is either the 1st choice or Alternative kit available?

15. For staff use; please leave blank.