Our library currently receives: 4 days/week Delivery 2 days/week Delivery NO Delivery | |
Our library would like to: Purchase 2 day/week service Purchase 1 additional day of service Begin 2 day/week service Other (please explain): |
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Library Name: | |
Contact: | |
Address 1: | |
Address 2: | |
City, St, Zip: | |
Telephone: | Fax: |
E-mail Address: | |
BILLING INFORMATION: | |
Check Here if Billing Address is the Same as Address Above | |
Address 1: | |
Address 2: | |
City, St, Zip: | |
Telephone: | Fax: |
Please describe where the driver should enter the building and give directions to the library or where deliveries/pickups should be made: | |
Please describe where deliveries should be made (i.e. Circ Desk, Main Office, etc.): | |
I have read the Regional Delivery Service Guidelines found at hrlc.org/delivery-guidelines.htm and agree to all terms and conditions, including submitting Delivery Statistics. |
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_______________________________________________ Signature |
___________________________ Date |