EmailMe Form - Barrington Public Library

Your Information

Your Name *

First Last

Your Library Card Number *

Please contact me via *

Telephone

E-Mail

Your Phone Number *

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Your Email Address *

Information About the Item You Are Requesting

Date of Request *

MM / DD / YYYY

Title *

Full Title of Item / Article Requested (include magazine title and issue / page numbers if applicable. (One per form please)

Author / Actor *

If the Author is unknown, please include the editor's name or the publisher's name

Format *

Date of Publication (if known)

Should this item not be found in the State of New Hampshire, we can do an out-of-state search for the item for a fee of $4.00, payable at the time you pick up the item at the library. Would you like us to perform an out of State Search for this book? *

Yes, I would like to order a search

No thanks!

This item is not needed after this date

MM / DD / YYYY

Notes to Librarian

Is this item needed for an upcoming book discussion?

Yes

No

Scheduled date of book discussion

MM / DD / YYYY

Date the the item is needed

MM / DD / YYYY