The Kit is for

Library Card Number

Parent's Name

Address

Zip Code

Phone Number

Email Address

Vacation Destination

Flying or Driving
FlyingDriving

Date Leaving

Date Returning

Pickup Date

Select Pickup Location
Main LibraryEola Road Branch

Child 1's Name

Child 1's Gender
BoyGirl

Child 1's Age

Child 1's Grade

Child 1 Reads Alone or Is Read To?
Reads AloneIs Read To

Child 1's Reading Level
 P E YF J YA

Child 2's Name

Child 2's Gender
BoyGirl

Child 2's Age

Child 2's Grade

Child 2 Reads Alone or Is Read To?
Reads AloneIs Read To

Child 2s Reading Level
 P E YF J YA

Child 3's Name

Child 3's Gender
BoyGirl

Child 3's Age

Child 3's Grade

Child 3 Reads Alone or Is Read To?
Reads AloneIs Read To

Child 3's Reading Level
 P E YF J YA

Child 4's Name

Child 4's Gender
BoyGirl

Child 4's Age

Child 4's Grade

Child 4 Reads Alone or Is Read To?
Reads AloneIs Read To

Child 4's Reading Level
 P E YF J YA

Formats:
 Books Magazines Books on Tape Books With Tape Books on CD Books with CD

Audio Visuals:
 CDs Video Cassettes

Other Special Requests:

Enter the series of Letters and numbers into the box below: