Book Cart Request Form

For any questions about this form, please contact Youth Services Librarian Katherine Freund (715) 823-7133, kfreund@clintonvillelibrary.org

1 Start 2 Complete

Your Name *

School Phone

Home Phone

School

Collection Information

Subject *

Reading Level

Grade

Include

Fiction

Non-fiction

Duplicates (Is it okay to gather two of the same book?)

Yes

If you would like multiple copies of the same title, please include the title and the number of copies you would like.

Title

# of copies needed

I want to pick up the materials on this date

Month

Day

Year

Additional information or comments