Teacher Request Form
Use this form to request items for your classroom lessons.
If you have any questions, contact Amy vanGoethem, Student Services Coordinator
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Adler Park School
Copeland Manor School
Highland Middle School
Hawthorn Elementary North
Hawthorn Elementary South
Hawthorn Middle School North
Hawthorn Middle School South
Hawthorn School for Young Learners
Hawthorn School of Dual Language
Oak Grove School
St. Joseph's Catholic School
St. John's Lutheran School
East Lake Academy
Libertyville High School
Vernon Hills High School
If you selected other above, with what school are you affiliated?
When would you like to pick up your materials?
Please allow at least 7 business days
How would you like to receive these materials?
Delivery is available to the district offices of District 68, District 70, and District 73
Pick up at Aspen Drive Library in Vernon Hills
Pick up at Cook Park Library in Libertyville
Types of materials needed
Please check all that apply.
Grade level of students
Please select all that apply.
Age of students
Reading level of materials you are requesting
Please check all that apply
at reading/grade level
below reading/grade level
above reading/grade level
Intended use of materials
For example, student reports, read-alouds, teacher back ground information
List of specific titles (if known)
May we substitute titles on the list above?
If we do not own a specific title you requested, would you like us to request it from another library?
Please note: Due dates are usually established by the lending library.
Number of students using the materials
Send me a copy of my responses.
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