Teacher Collection Request Form

Library staff will select a collection of age/grade appropriate materials on a specific topic for use in your classroom. To request this service, you must have a valid Teacher Card and work within the MidPointe Library System service area.

With a 2-week notice, each teacher may request one collection per month. Materials come from the Library system’s collections. Library staff fill all requests as completely as possible. We reserve the right to limit the number of items borrowed that are currently in demand, including seasonal and holiday items.

Your collection will be ready on the pick-up date set on this form. You may choose to have library staff contact you if your collection will be ready sooner. Your collection must be picked up within 3 days of the pick-up date. After the second time a collection is not picked up, Teacher Collection privileges will be suspended for the remainder of the school year.

Pick Up Date

Pick Up Location

Please contact me if my collection is ready early.

Teacher's Name:

Teacher's Card Number:

Email:

Phone Number:

School:

Grade:

Reading Level (if different than grade)

Number of items requested

Topic/Assignment Description and Subjects Requested:

Collections can include:

Specific Titles (Limit 5):

Additional Information

Teacher Collection Request Form

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