SCHOOL
APPLICATION FOR LIBRARY SERVICES
A separate application must be submitted for each student; Duplicate this Application form if you need additional copies.
--------------------------------------- PLEASE PRINT ---------------------------------------
School Name___________________________________________________
Mailing Address_________________________________________________
City_________________________ State__________________ ZIP_______
Student's Name ________________________________________________
Student's Date of Birth ______________________ Male _____ Female _____
Teacher's Name ________________________________________________
The books offered by the KENNETH JERNIGAN LIBRARY are available in the following Grade levels:
CHECK Only one grade level.
_____ Pre-School _____ Grade 4
_____ Kindergarten _____ Grade 5
_____ Grade 1 _____ Grade 6
_____ Grade 2 _____ Grade 7
_____ Grade 3 _____ Grade 8 (young adult)
This application to be used only for book services sent directly to school.
Signature ____________________________ Date ____________
Additional Information for School and Itinerant Teachers
BOOKS ARE SENT TO THE SCHOOL, ATTENTION OF THE TEACHER.
Library service is provided either at school or home, but NOT BOTH. However, if you would prefer that the books be sent to the student's home instead of the school, a HOME SERVICE APPLICATION is available from our library.
Library books are loaned free of charge to subscribers for a period not to exceed 2 months. Overdue books will suspend lending privileges.
Return books to library in same mailing-box in which books were sent. It is only necessary to pull out the mailing label and reverse it. The return address is printed on the reverse side of label.
NO POSTAGE IS REQUIRED.
Please call our attention to damaged books or books with missing pages.