Testing the form

Teacher's Name (required)

Teacher's Email (required)

Teacher's Phone Number (required)

Teacher's Library Card No.

School Name (required)

School Phone Number (required)

What is your objective (include copy or assignment, if possible)

Dates materials are needed (starting/ending)

 Fiction Non-Fiction DVDs Picture Books

Supplemental Classroom Collection books will be checked out by the teacher. Teachers will be responsible for all items checked out on their personal library cards. Materials to be used in the classroom only. Student Checkout Collection books will be checked out by individual students. Students may come to the library to check out these items on their own personal library cards.

 Supplemental Classroom Collection Student Checkout Collection

Please indicate preferred library pickup location:
 James Blackstone Memorial Library Willoughby Wallace Memorial Library