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Interlibrary Loan Request Online Form

2. Title*
3. Author*
5. Format

   1. Book
   2. CDs

   1. DVDs
   2. Other
6. Further information if format is "other."
8. How did you hear about this title?
10. First Name*
11. Last Name*
13. Your Burlington Library Card Number*
    Please enter the 14-digit number from the back of your card, with no spaces.
15. Is the Burlington Public Library your home library?*

    1. Yes
    2. No
17. If no, have you requested this book or DVD from your home library?

    1. Yes
    2. No
19. Email
20. Phone
22. I understand that all items borrowed will be picked up and returned to the Burlington Public Library.*

    1. Yes
Leave This Blank:


24. 1. Receive an email copy of this form.
25. Email address

    This field is not part of the form submission.

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