Pop-Up Library Form Pop-Up Library Request Form * indicates a required field Name * Required First Last Title and/or OrganizationPhone * RequiredEmail * Required Event Name * RequiredEvent Summary * RequiredDo you charge a fee to participate at your event? If so, how much? * RequiredEvent Date - must be mm/dd/yyyy format Date Format: MM slash DD slash YYYY Start Time * Required HH : MM AM/PM AM PM End Time * Required HH : MM AM/PM AM PM Event Address * Required Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Where would you like our Pop-Up Library Van to park? * RequiredPlease 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 AttendanceSpecial 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 CAPTCHAPhoneThis field is for validation purposes and should be left unchanged.
