Application for Bookmobile Service

* indicates required field

Part A - Contact Info

*Name of Organization:
Address of Organization:
Cross Streets:
*Name and Title of Contact Person:
*Phone Number:

Part B - Bookmobile Use

*Event Name or Type of Organization:
Closest BPL branch: View Map
*Time and Date of Event:
*Number of people expected:
*Location to park bookmobile: (include cross streets, 2 adjoining parking spaces are required)