Boston Harbor Islands Library Pass Program 2017
Please fill out this form by March 10th, after April 10th we will begin to outreach to additional libraries.
Date *
MM
/
DD
/
YYYY
Library Name *
Your answer
Contact Name *
Your answer
Contact Phone *
Your answer
Contact Email *
Your answer
Street Address *
Your answer
City/Town *
Your answer
State *
Your answer
Zip Code *
Your answer
Have you Participated in the Boston Harbor Islands Library Pass Program Before *
Have you Participated in the Boston Harbor Islands Library Pass Program Before *
If you participated in the past, how many passes did your library use in 2016?
Your answer
Which program are you interested in bringing to your library? *
You can pick both options
Required
How many $5.00 passes would you like to purchase?
Your answer
Name of your Local Paper
Your answer
How will this pass be promoted in your community? *
Your answer
How will this pass support your mission? *
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of Boston Harbor Island Alliance. Report Abuse - Terms of Service