Book Club Book Request Form
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Name of Book Group *
Contact Person *
Email
Phone Number
Date of meeting *
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/
DD
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YYYY
Date book is needed by *
MM
/
DD
/
YYYY
Number of Copies needed *
Title of Book *
Author *
Do you need a large print copy?
Use the "other" option if you need more than one copy.  Write the number of copies you need on the space provided.
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Notes
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