LONG BEACH PUBLIC LIBRARY
111 West Park Avenue, Long Beach, New York 11561
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Long Beach Public Library Youth Services
School Assignment Form

School:   Teacher:   Grade:

Number of Classes:   Total Number of Students:  

Contact Person:   Contact Phone Number:

Date Given:   Date Due:

Assignment Topic Description:

Should these items be made temporary reference? yes    no


  

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Date Received:    Interlibrary Loan?:    Limit Circulation?: