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Teacher's Collection Request Form
Book collection requests for Cheilon/ Youth Services
Staff Completing Form (if applicable)
Your answer
Teacher Name (as it appears on library account) *
Your answer
Library Barcode *
Find number on back of teacher card. Begins with 2792500.
Your answer
School *
Your answer
Phone Number *
Your answer
Email Address *
Your answer
Work Phone Number *
Your answer
Date for Pick-up *
Ten weekdays are required to prepare collections to be picked up at any location.
MM
/
DD
/
YYYY
Pick up location *
Number of Books *
Max is 20
Your answer
Subject and/or Titles Requested *
Your answer
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