ILL or Book Club Request

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* 1. Patron Name:

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* 2. Date:

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* 3. Phone Number:

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* 4. Library Card Number:

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* 5. Title:

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* 6. Author:

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* 7. Subject or Helpful Information:

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* 8. If this is a Book Club request, how many copies would you like?

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* 9. There is a $5.00 fee for each ILL item requested, to be be collected when you pick up the ILL item. When ordering books for a Book Club, the fee is $10.00 for the set. If you refuse or do not pick up the item, your account will be charged. Late items will be charged $1.00 per day. Ill items cannot be renewed and must be returned on or before the due date. I have read and agree to these rules.

I agree to these rules.

I do not agree to these rules.