Materials Request Form

Please use this form for suggesting materials you would like to see added to the Loutit District Library collection.  When completed, this form should be submitted electronically or returned to the Reference Desk at the library.  The librarians will review your request with respect to the Loutit District Library Collection Development Policy to determine if the material fits the collection.  

Date 

Name

Address 

Phone                 E-mail 

Citizen Represents:  Self        Organization

Title of Item 

Author 

Publisher 

Format   Book      Video/DVD      CD/Cassette      Magazine      Other

Have you read or heard any critical reviews of this work?    Yes      No

If so, where? 

Why do you feel this item should be added to the collection?

Would you like us to contact you if the item is purchased?     Yes      No