Zip Books Request Form

Name: (required)

Library Card Number: (required)

Email: (required)

Phone: (required)

Address: (required)

City: (required)

County: (required)

State: (required)

Zip: (required)

Special Delivery Instructions:

Title: (required)

Author: (required)

Publication Date: (required)

ISBN: (required)

Format: (required)

Price: (required)

Zip Books Request Terms and Conditions

I acknowledge that:

1) I can submit a request for 1 item per calendar month and can only request another item when the previous item has been returned in good condition.

2) The item will be delivered to my address as indicated on the request sheet by Amazon.

3) I will return the item directly to a Buena Park Library staff member with its original packaging and Amazon packing slip.

4) My account will be charged full price of the item if it is not returned or returned damaged.

Signature: (required)

Date: (required)

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