Digitizing Project Submission Form

Please Print out this form and submit it with your materials.

Wauconda Area Library
Local History Digitization Project

Materials Submission Form

It's easy to submit materials for inclusion in our Local History web site!

Simply complete the white areas of this form and submit with your material(s) at the library's Information Desk. We'll return your material(s) to you as soon as we have scanned them -- usually within one week.

Name of owner of material(s)_______________________________________________________________________

Name of person submitting material(s) (if different from owner)__________________________________________

Address__________________________________________________________________________________________

Phone: Home________________ Work___________________

Brief description of item(s): ________________________________________________________________

_________________________________________________________________________________________

_________________________________________________________________________________________

_________________________________________________________________________________________

Number of items _______ Date submitted___________ Staff's initials_______ Tracking no.__________

I have read and understand the Materials Submission Guidelines. ________________________________

Signature of owner of item(s) submitted

RECEIPT

Name of person submitting items__________________________________________

Number of items _______ Date submitted___________ Staff's initials_______ Tracking no.__________

Please note: Although the Wauconda Area Library does not accept responsibility for the security and safe-keeping of materials submitted for the Digitizing Project, every effort will be made to return materials to their owners as quickly as possible in the same condition in which they were submitted. All materials will be available for pickup at the library within one week of submission unless otherwise noted.

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