Ready To Learn Material Request Form

Fax this form to (989) 774-4427
or mail it to:
1999 E. Campus Dr.
Mt. Pleasant MI 48859
Attention: Charlotte Galgoci
(989) 774-3610

Today’s date:_________________

Name_______________________________ Program________________________________

Mailing address (if necessary) ______________________________________________________

_____________________________________________________________________________

Phone__________________________________

Event Date_____________________________________________________________

I need the materials by:(please allow 2-3 days before event to preview materials) _________________________________________________________________________

Description of event:______________________________________________________

Theme (if available):_______________________________________________________

Name of video:__________________________________________________________

Name of book:__________________________________________________________

Activity:________________________________________________________

Do you need help finding an activity?_____________ ages of children participating _____________

*Please make request at least two weeks before event is to take place.
*Materials are to be returned within one week of event
*Any books returned damaged will must be replaced at the expense of the borrower.
*There is a $1 a day charge for any videos and books not returned within one week of event date,
  unless other arrangements have been made.