Pop-Up Library Form Pop-Up Library Request Form "*" indicates required fields Name* First Last Title and/or Organization Phone*Email* Preferred Method of Contact*PhoneEmailEvent 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 CAPTCHAUntitledFirst ChoiceSecond ChoiceThird ChoiceNameThis field is for validation purposes and should be left unchanged.
