Request for Purchase

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Print out this form and leave it in any library suggestion box! 
 join the Teen Advisory Board!  call for details: 978/373-1586
 

Please add the following item to the library collection: 

Title: ___________________________________________________

 
Author/Artist:
____________________________________________

 

Format (circle one):   
Book                  Magazine             Video  Game
                               

Video      DVD        CD (music)    CD-ROM       

 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:
___________