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Patron Request for Purchase
J.V. Fletcher Library
Today’s Date: _______
*Please complete as much information as possible.*
Title: _______________________________________
Author (if applicable):_________________________________
Publisher: ____________________ ISBN:___________________
Format-- Underline One
Book CD Books on Tape/CD Video DVD
OPTIONAL:
If the Library selects to purchase this item, would you like
to place it on hold? ___________
Name: __________________________ Library Barcode: _______________
Phone Number: __________________ E-Mail Address: _________________
Staff Only:
Route to selector for following collection , "X" next to one
Adult: ____ Juvenile: ______Reference: ______ Fine Arts: _______ Bookmobile: ______
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