Rhizome Infoshop Checkout Form
Please fill out this form to request media checkout (books, zines, DVD's)
FIRST NAME/NOMBRE
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LAST NAME/APELLIDO
Your answer
MEMBERSHIP NUMBER/NUMERO DE MEMBRESIA
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MEDIA TITLE (BOOK, ZINE, CD)/TITULO DE MEDIO (LIBRO, REVISTA, CD)
Your answer
DATES & TIME AVAILABLE TO MEET/HORARIO CUANDO PUEDE REUNIRSE
Your answer
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