The Library Bookstore

Name:___________________

Phone#__________________

Item being requested: (please check one)

□Book □DVD (movie) □VHS (movie)

□Book on CD □Book on Tape □CD (music)

Author/Artist:_____________________________________

Title:____________________________________________

:::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::

Library Use Only:

Price:____________ (tax not included)

Ordered:_________

Received:_________

Called Patron:______

_________________________________________________