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2. All vehicle outings are limited to locations in Cornelius, OR. (Or within 10 miles of the library.)

4. Name of Organization:*
5. Type of Organization:*

   1. School
   2. Daycare
   3. Other
7. Address:*
9. City*
10. State:*
11. Zip Code:
13. Contact Person:
14. Contact Email:*
16. Organization Phone Number:*
17. Day of Event Phone Number (Cell Phone):*
19. Date of Outing:*
    Date of Outing:
20. Start Time of Outing:*
    Start Time of Outing:
21. End Time of Outing:*
    End Time of Outing:
23. Number of People Expected:*
24. Languages Spoken by Students/Participants:*

    1. English
    2. Spanish
    3. Other
26. Which Community Outreach Bookmobile Services Are You Requesting?*

    1. Library staff bring library services & information to you (No bookmobile)
    2. Kids Bookmobile Service
    3. Bookmobile Service
Leave This Blank:


28. 1. Receive an email copy of this form.
29. Email address

    This field is not part of the form submission.

30. Submit

* indicates a required field