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Get Resource Lending Form 2011 - Vcu

Ction Send To: NAME: AGENCY: ADDRESS: CITY STATE ZIPCODE Return: (date 5 weeks from today) Is this material for a DB/DSI Child? Y N If YES, then: Are you related to the child? Y N Do you work with the child? Y N Child's Name: If NO then: Does child have HI? Y N Does child have VI? Y N * Books and CD/DVD may be borrowed for 1 month. If you need them longer, you must call or email me (contact information above). ** You are responsible for returning all borrowed materials ** Retu.

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