Patron Template Request Form
Date:
Library:
Name of person to contact:
Phone number:
Indicate which fields you wish to include:
In the template make this line blank or supply the following information:
Check box if you want the template to prompt for this field automatically:
Fixed-fields:
Expiration Date
Age Range
Ward
Residence
Status
Patron Type
Birth date
Home library
Manual block
School, etc.
Patron Agency
Notice preference
Variable-fields:
Name
Guardian
Name Prefix
Name Suffix
Address
Address 2
Telephone
Telephone 2
License #
Message
Note
Barcode
Email
Pin #
Please add any additional instructions: