Classroom Visit Request
Teacher Name
*
Email
*
Phone Number
School
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Grade Level(s)
*
How many students will be in attendance?
What topics would you like us to cover?
*
Library resources that will help students with homework and research projects
Fiction and nonfiction titles that relate to a topic being discussed in class
How to get a library card and what comes with it
Popular, age-appropriate titles to get students excited about reading for fun
Other
What is your 1st date choice for us to visit you?
*
-
Month
-
Day
Year
You may enter up to three dates. Every attempt is made to meet your preference, however, adjustments may be needed based upon staff availability.
What is your 2nd date choice, if any?
-
Month
-
Day
Year
You may enter up to three dates. Every attempt is made to meet your preference, however, adjustments may be needed based upon staff availability.
What is your 3rd date choice, if any?
-
Month
-
Day
Year
You may enter up to three dates. Every attempt is made to meet your preference, however, adjustments may be needed based upon staff availability.
What is the preferred time(s) for us to visit?
*
Every attempt is made to meet your preference, however, adjustments may be needed based upon staff availability.
Please include any other details and describe any specific goals or needs of your students:
*
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