The Lane Libraries Classroom Collection Request Form
Teacher Cards Only - Please allow at least 2 weeks for a collection to be prepared.
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Email *
Teacher Name *
School *
Phone #
Teacher Barcode Number *
All barcodes should begin: 21842
Grade
Room Number
Pick Up Month *
or Drop-Off Month (for Bookmobile collections)
Pick Up Day *
At least two weeks advance notice is needed.  If Bookmobile is dropping off your collection, choose BOOKMOBILE (bottom of list).
Please Choose Your Pick Up Location *
Subjects *
Please tell us what subject(s) you need and how you will use the materials (eg. silent reading, pair reading, reading aloud, independent reading, student research projects etc.);  Include as many details as possible.
Collection Should Include *
Check all that apply.  Please select at least one.
Required
Specific Titles
Please list any specific titles you would like.
Reading Levels *
Number of Items Needed *
Thank You!
A copy of your responses will be emailed to the address you provided.
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