Assignment Form

Terrell County Public Library

School Assignment Alert Form

Terrell County School Instructors: Filling out this form will notify the Terrell County Public Library about assignments you have planned for your students. Giving the library advance notice about the assignment will help us to better prepare for your visiting students and gear resources based on the details you provide.

If possible, please complete this form and fax to (912) 995-5989. This form may be returned or mailed   to:
        Terrell County Public Library
        913 Forrester Drive
        Dawson, Georgia 31742

Note: If you choose to mail this form, please mail it at least one week (five business days) before the assignment is to begin.

Name: Date:

I am a/an Other

Name of School

Title of the Assignment:

When is the assignment due:

Grade Level Number of Students:

Description of the assignment (What kind of information students
are expected to find?

What are the details of the assignment?)

Indicate each type of source required for completion of the assignment
(Please check all that apply):

Any Source may be used
Books
Reference Materials
Magazines
Newspapers
The Internet
Library Databases

Other Assignment Restrictions:

Please indicate a preferred method of contact for us to reach you if we have a question:

Telephone What would be a convenient time to contact you:
Your phone number:

E-Mail Your E-Mail address:

Fax Your fax number is:

NOTICE: This form can be submitted by . Please send the form at least three days before the assignment begins.

To clear this form, press the Reset button.

Feedback: Claudia Copeland, Librarian
This page last updated: July 25, 2004

2004�   Terrell County Public Library
                Dawson, Georgia 31742
                Claudia Copeland, Librarian
                Romaine Richardson, Web Master
                Last Updated: July 25, 2004
All rights reserved. Reproduction in whole or in part without the express permission of Terrell County Public Library is strictly prohibited.