*Institution you are representing(Required.)

Amagansett Public LibraryAmityville Public LibraryBabylon Public LibraryBayport - Blue Point Public LibraryBayshore - Brightwaters Public LibraryBrentwood Public LibraryBrookhaven Public LibraryCenter Moriches Public LibraryCentral Islip Public LibraryCold Spring Harbor Public LibraryCommack Public LibraryComsewogue Public LibraryConnequot Public LibraryCopiague Public LibraryCutchogue - New Suffolk Public LibraryDeer Park Public LibraryEast Hampton Public LibraryEast Islip Public LibraryElwood Public LibraryEmma S. Clark Public LibraryFloyd Public LibraryHampton Bays Public Library Public LibraryHampton Library in Bridgehampton Public LibraryHalf Hollow Hills Public LibraryHarborfields Public LibraryHauppauge Public LibraryHuntington Public LibraryIslip Public LibraryJohn Jermain Public LibraryLindenhurst Public LibraryLong Island Resources CouncilLongwood Public LibraryMastics Moriches Shirley LibraryMattituck - Laurel Public LibraryMiddle Country Public LibraryMontauk Public LibraryNorth Babylon Public LibraryNorth Shore Public LibraryNorthport - East Northport Public LibraryPatchogue - Medford Public LibraryPort Jefferson Public LibraryQuogue Public LibraryRiverhead Public LibraryRogers Public LibrarySachem Public LibrarySayville Public Library Shelter Island Public LibrarySmithtown Public LibrarySouth Country Public LibrarySouth Huntington Public LibrarySouthold Public LibraryWest Babylon Public LibraryWest Islip Public LibraryWesthampton Public LibraryWyandanch Public LibraryInstitution not listed

*Name and contact information(Required.)

First Name

Last Name

email

cell number

*I will be on the 1 day bus roundtrip (Leaving and returning February 28th)(Required.)

Pickup SCLS 6:00AM

Pickup LIE Exit 58 6:15AM

Pickup LIE Exit 49 6:30AM

I am a

Library Staff Member

Library Trustee

Friend of the Library

Library Patron

State Senate District

State Assembly District