Request Classroom Materials
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Library Card Number
*
*
I understand that my Yavapai Library Network library card will be used to hold and check out the requested items.
School Name
*
Grade Level
*
Topic or Subject Area(s)
*
Please provide a complete description of the assignment and subject or materials needed. The more we know, the better we can meet your needs.
Number of Items Needed
*
Limit 20
Requested Pickup Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Please allow at least 7 days
Types of Materials Needed
*
Picture Books
Stories (Fiction)
Informational Books (Non-Fiction)
Biographies
DVDs
Music CDs
Audiobooks on CD
Other
Please verify that you are human
*
Submit
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