ONEBOOKAZ 2012 Book Request and Author Request Form


	BOOK ORDERS:


	WHO IS ELIGIBLE TO RECEIVE BOOKS? Public, academic and K-12 school libraries are eligible for books if they hold ONEBOOKAZ programs that are free and open to the public (except K-12 school locations limited to students) or use the books in instruction, and acknowledge the State Library as the donor. If you are not associated with a library, we encourage you to contact your local library and let them know of your interest in this book and the opportunity to request copies from the State Library Please complete this book order form and submit it by January 13th. Books will be distributed according to eligibility. One shipment per location will include books, posters, bookmarks and educational materials. Packages will be shipped in February.

How does your library plan to use the books?

	For class discussion / study
	For library's collection / circulation
	For book clubs
	Other, please specify

Select quantity for Arizona: 100 Years Grand

	0
	1
	4
	8
	12
	Other, please specify

Select quantity for Arizona Way Out West & Witty

	0
	1
	4
	8
	12
	Other, please specify

Your mailing address (where the books should be shipped)

Name
Company
Address 1
Address 2
City
State
Zip
Email Address

Please enter a daytime telephone number where we can reach you if we have any questions.

Telephone

These books are intended for lending, instruction, continual book discussion and promoting literacy. By requesting and receiving books, you agree that they will not be offered for resale or as door prizes.

If you understand these terms and conditions, please type your name in the following box:

Name


	Please click the "submit" button to navigate to the second page, which is the Author Request form. Even if you don't want to order books at this time, you have to hit the "submit" button in order to access the second page. It's okay to leave this first page blank and continue on to the second page.