Item/Information Request Form

1. Item/Information Request Form Name:______________________________________Date:________________ Library Card #____________________________Phone #:________________ The Library may contact me at this Email Address:______________________________ By providing your Email address on this form, you give permission to the Newburyport Public Library to communicate with you via Email. Please contact the Library if your Email address changes. We will not share your Email address outside the Library. For Staff Use 1. Title:__________________________________ ISBN:_________________________ Author_______________________________ Type of Material:______________ 2. Title:__________________________________ ISBN:_________________________ Author_______________________________ Type of Material:______________ 3. Other Items or Information Needed: Initials Item/Information Request Form Name:______________________________________Date:________________ Library Card #____________________________Phone #:________________ The Library may contact me at this Email Address:______________________________ By providing your Email address on this form, you give permission to the Newburyport Public Library to communicate with you via Email. Please contact the Library if your Email address changes. We will not share your Email address outside the Library. For Staff Use 1.Title:__________________________________ISBN:_______________________ Author_______________________________ Type of Material:______________ 2.Title:_________________________________ISBN:________________________ Author_______________________________ Type of Material:______________ 3. Other Items or Information Needed: Initials