Pop-Up Library Form Pop-Up Library Request Form "*" indicates required fields Name* First Last Title and/or Organization Phone*Email* Event Name* Event Summary*Do you charge a fee to participate at your event? If so, how much?* Event Date MM slash DD slash YYYY Start Time* Hours : Minutes AM PM AM/PM End Time* Hours : Minutes AM PM AM/PM Event Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Where would you like our Pop-Up Library Van to park?*Please note: It is 9 1/2 feet high and 24 feet long with the customer entrance and extendable awning on the passenger side. A lift in the back can provide wheelchair accessibility if there is additional length for our space and a flat surface behind the van. Estimated Attendance Special Services of InterestSpecific types of materials for the Pop-Up to bringAre restrooms available to library staff? Yes No Is a drinking fountain or free water available for library staff? Yes No CAPTCHAEmailThis field is for validation purposes and should be left unchanged. Close Can you tell me more about this webform submission? The contents of this webform are sent to library staff via email. We recommend that you do not submit confidential information (like your library card number, passwords or credit card information). If you need to share confidential information with library staff, we suggest that you use other channels of communication, such as the telephone.Visit our Privacy Statement, opens in a new window, opens a new window to learn more about how your personal information is handled and protected. This information will be submitted via email. Learn More about sending data over email.