ORDERS ARE SENT DIRECTLY TO VENDOR 

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Library Name

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Address

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City, State, Zipcode                                                                                 

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Contact                                                                              

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Phone with extension                                     

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Fax

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Email

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Technical Contact Name                                                                         Title

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Phone with extension      

Does your library access the Internet through:
___ a modem/individual dial-up connection
___ a network; Provide your IP address or range: __________________________________
                                    

SCHOOLS: PLEASE COMPLETE IF YOU WANT BILL SENT DIRECTLY TO DISTRICT OFFICE 

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Address

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City, State, Zipcode

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Billing Contact Name                                                                                 Phone/Fax