Request for Purchase

Print out this form and give it to any librarian at the Reference/Information Desk
 

Please add the following item to the library collection: 

Title: ___________________________________________________

 
Author/Artist: ____________________________________________

Format (circle one):   
Book                  Magazine             Video  Game       DVD        CD (music)        

 Include your name and contact information!  We'll be more likely to order the item, AND put we'll you first on the waiting list!

Your name will be entered in a weekly raffle for free books!

First & Last Name: ________________________________________

Phone/Email:  _____________________________________________ 

Age: ___________