Springfield Library: Fax Request Form

Springfield Library Fax Reference

YOUR NAME:___________________________________________________________

CITY/TOWN OF RESIDENCE:___________________________________________

FAX NUMBER_______________________________DATE/TIME___________________

TELEPHONE NUMBER____________________E-MAIL___________________________

QUESTION OR OTHER REQUEST:___________________________________________

_____________________________________________________________________

If requesting library materials, ILL, or reserve:
C/WMARS Card No: ____________________________________________________

Mailing Address: _____________________________________________________

IF REQUESTING OBITUARY:

Name of Deceased:_____________________________________________________

Date of Death & City/Town of Residence:_______________________________

FORM OF RESPONSE REQUESTED: (Fax, telephone, e-mail, regular mail):

_____________________________________________________________________