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* 1. First Name

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* 2. Last Name

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* 3. Library Card Number

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* 4. Mailing Address

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* 5. Special Instructions For Delivery

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* 6. Phone Number

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* 7. Email Address

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* 8. Title of Requested Item

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* 9. Author of Requested Item

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* 10. Format of Requested Item

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* 11. Additional Comments

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* 12. Please read the following rules and information, and acknowledge at the bottom to submit your request.

Zip Book requests are processed in the order they are received. Once this survey is submitted, it may take up to three (3) weeks before the order is processed and the item is delivered. You will receive an email when your request is processed to update you on the status.

By submitting this request, I understand that:

• I can only have five Zip Books requested per month, per library card.
• My requests must be available from Amazon for under $50 ($75 for foreign language and audiobook titles) pre-tax.
•Textbooks, test preparation, and study guides will only be purchased if they are in agreement with Riverside Public Library's collection development practices.  
• My Zip Book will be delivered to the address I provided above.
• I must return my Zip Book to a Riverside Public Library employee, not a book drop.
• Returning a Zip Book more than three (3) weeks after the delivery date will result in late fees being charged to my account at a rate of $.25 per day, to a maximum of $5.00.
• My account will be charged the full price of the book if my Zip Book is not returned by six (6) weeks after the due date.

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