2. 
4. Please only submit 1 grab bag request per card per week.
6. First Name*
7. Last Name*
9. Library Card Number*
10. Phone Number or Email Address:*
12. Please specify the age or grade of the child:*
13. Which formats would you like?*

    (check multiple)

    1. Board Books
    2. Picture Books
    3. Vox Books
    4. Early Readers
    5. Chapter Books
    6. Juvenile Books

    1. Nonfiction Books
    2. Teen
    3. Graphic Novels
    4. DVDs
    5. Spanish Language
15. Please write up to 5 interests:*
    These will help us determine which items we will pick for you.
17. General Comments
19. Please note:

    A librarian will pick up to 20 items for you. Please wait to pickup these items until you have received notification that your items are being held on the hold shelf for you. Please allow at least 72 hours for your request to be processed. Requests will only be filled with items available on Fitchburg's shelves.

Leave This Blank:


21. 1. Receive an email copy of this form.
22. Email address

    This field is not part of the form submission.

23. Submit

* indicates a required field