2. First Name*
3. Last Name*
5. Library Card Number
   If you do not currently have a library card, please call the library (507-304-4001) to get set up with a temporary card.
6. Phone Number
8. Please choose a pick-up location.*
   -- Select One --Blue Earth County Library - MankatoLake Crystal Public LibraryMapleton Public Library
10. Please fill in the information for the items you are requesting
12. Item 1 - Title
14. Item 1 - Author
15. Format
    -- Select One --PrintAudioLarge PrintDVDBlu-ray
17. Item 2 - Title
19. Item 2 - Author
20. Format
    -- Select One --PrintAudioLarge PrintDVDBlu-ray
22. Item 3 - Title
24. Item 3 - Author
25. Format
    -- Select One --PrintAudioLarge PrintDVDBlu-ray
27. Item 4 - Title
29. Item 4 -Author
30. Format
    -- Select One --PrintAudioLarge PrintDVDBlu-ray
32. Item 5 - Title
34. Item 5 - Author
35. Format
    -- Select One --PrintAudioLarge PrintDVDBlu-ray
37. Item 6 - Title
39. Item 6 - Author
40. Format
    -- Select One --PrintAudioLarge PrintDVDBlu-ray
42. Item 7 - Title
44. Item 7 - Author
45. Format
    -- Select One --PrintAudioLarge PrintDVDBlu-ray
47. Item 8 - Title
49. Item 8 - Author
50. Format
    -- Select One --PrintAudioLarge PrintDVDBlu-ray
52. Item 9 - Title
54. Item 9 - Author
55. Format
    -- Select One --PrintAudioLarge PrintDVDBlu-ray
57. Item 10 - Title
59. Item 10 - Author
60. Format
    -- Select One --PrintAudioLarge PrintDVDBlu-ray
62. Item 11 - Title
64. Item 11 - Author
65. Format
    -- Select One --PrintAudioLarge PrintDVDBlu-ray
67. Item 12 - Title
69. Item 12 -Author
70. Format
    -- Select One --PrintAudioLarge PrintDVDBlu-ray
72. Item 13 - Title
74. Item 13 - Author
75. Format
    -- Select One --PrintAudioLarge PrintDVDBlu-ray
77. Item 14 - Title
79. Item 14 - Author
80. Format
    -- Select One --PrintAudioLarge PrintDVDBlu-ray
82. Item 15 - Title
84. Item 15 - Author
85. Format
    -- Select One --PrintAudioLarge PrintDVDBlu-ray
87. Comments
Leave This Blank:


89. 1. Receive an email copy of this form.
90. Email address

    This field is not part of the form submission.

91. Submit

* indicates a required field