Book Bounce Request

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Contact Information

Book Bounce Request

BOOK BOUNCE REGISTRATION AND KIT REQUEST FORM

Applicant Information

Name

Address

City

State

Zip Code

Phone Number

Email Address

Library Card Number

Organization Information

Daycare, School, or Program Name

License Number

Director Name

Select a choice

Same as above

Address

City

State

Zip Code

Phone Number

Email Address

Book Bounce Kit Information

Please list the kit you would like to checkout

please list 2 or 3 alternate kits in case your first choice is not available. For Windows: Hold Down the control (ctrl) button to select multiple options For Mac: Hold Down the command button to select multiple options

Please tell us when would you like to checkout the kit. please allow 1 week for us to process your request

Pickup Date

please select a date at least one week from today

Pickup Location

If you have any questions about the Book Bounce Kit program, please contact:

Ken Clarke

Public Services Outreach

Phone: 407.665.1552

Email: kclarke02@seminolecountyfl.gov

Multi Selected Values

If you have any questions about the Book Bounce Kit program, please contact:
Ken Clarke
Public Services Outreach
Phone: 407.665.1552
Email: kclarke02@seminolecountyfl.gov

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Book Bounce Request

BOOK BOUNCE REGISTRATION AND KIT REQUEST FORM

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