Please use this assignment alert form before giving your students an assignment that will require library materials. This information can be faxed in, sent through school delivery, e-mailed or submitted online. Once the library receives the form, materials will be gathered, and a pathfinder (list of selected age-appropriate websites) created if requested. Please fill out the form as completely as possible and allow at least 3 weekdays for your request to be fulfilled. Thank you in advance for your help!

Teacher Information

Teacher Information

Name: *

Teacher's name

School: *

School name

Home Phone:

Home phone number

E-mail address: *

Teacher's e-mail address

Library card number: *

Library card number

Assignment Information

Topic: *

Assignment topic

Number of books needed (subject to availability in library):

Grade Level: *

Date given:

MonthJanFebMarAprMayJunJulAugSepOctNovDec

Day12345678910111213141516171819202122232425262728293031

Year20112012201320142015

Date assignment given

Date due:

MonthJanFebMarAprMayJunJulAugSepOctNovDec

Day12345678910111213141516171819202122232425262728293031

Year20112012201320142015

Date due or date pathfinder to be taken down

Pathfinder needed:

Yes

No

Classroom collection needed?:

Yes

No

If yes, :

Pickup

Delivery

Additional information:

Please give as many details/requirements about the assignment as possible to help us prepare for your students.