Youth Services Outreach Request Form

School/Organization Name

Contact Name

First Name

Last Name

Contact Email

Contact Phone

We would like to:

Preferred Date for Library or School Visit: First Choice

Preferred Date for Library or School Visit: Second Choice

Preferred Date for Library or School Visit: Third Choice

Preferred Arrival Time

Preferred Departure Time

Number of Participants/Students

What would you like to do during your visit?

You may choose more than one.

Storytime

Library Tour

Research/Term Paper Help

Library Scavenger Hunt

Checking Out Materials

Book Talks

Library Resources Overview

Library Card Drive - This may require some pre-planning to assure cards are ready

Any special requests or accommodations?

Additional Comments

Main Branch