Akron-Summit County Public Library | Distrbution of Non-Library Materials Policy Form

Date of Request:

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Requested Date of Distribution(*)

Enter your desired date for distributing material.

Requesting Agency: (*)

Enter your agency name.

Address(*)

Enter your mailing address.

Web site:(*)

Enter your web site address.

Contact Person: (*)

Enter your full name.

Title: (*)

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Email: (*)

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Telephone: (*)

Enter your telephone number.

Fax: (*)

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501(c)3 Number:(*)

Please enter your 501(c)3 number.

Purpose/Goal: (*)

Please enter the purpose of your request.

Type of Material:(*)

Flyer (10 per location)Poster (1 per location, not to exceed 11" x 17")Brochure (25 per location, bundled)Newsletter/paper (25 per location, bundled) Please select one material type.

Distribution of Non-Library Public Relations Material Request Form