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2. If you would like to request that the Pella Public Library obtain an item we do not own, please fill out the form below. If you have any questions, please contact the library at 641.628.4268.
4. I would like the Pella Public Library to obtain a(n):*

   1. Adult book
   2. Adult audiobook
   3. Movie
   4. Children's / Young Adult item
   5. Music CD
   6. Magazine or Journal Article
   7. Other
6. Title:*
8. Author:*
10. ISBN #:
11. Edition
13. If the request is for a Magazine or Journal Article, please provide the information below.
15. Publication Title, Date, Volume/Issue Number, and Page Numbers
17. Your Contact Information
19. Your Pella Public Library Card Number:*
    Central College numbers cannot be used. If you are a Central College Student or Faculty, please apply for a Pella Public Library card prior to submitting this form. Call (641) 628-4268.
21. Last Name:*
22. First Name:*
24. Phone Number:*
26. Email Address:
28. I am a resident of Pella or Rural Marion County

    1. Yes
    2. No

    Note: For statistics only. This information does not affect how the above request is processed.

30. Additional Comments:
    Enter any additional comments or other helpful information here.
Leave This Blank:


31. 1. Receive an email copy of this form.
32. Email address

    This field is not part of the form submission.

33. Submit Submit and Print

* indicates a required field