September Teen Take Out Box
Use this form to sign up for the September TEEN TAKE OUT BOX and receive a librarian-picked book in your choice of genre as well as snacks and other goodies. You keep the goodies and return the book! Note: this service is for students in grades 6-12 only.  You need a valid Berlin-Peck Memorial Library card to register. Limit 1 Take Out Box per month.

Contact us at (860) 828-7127 if you need help filling out this form!
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LAST NAME: *
FIRST NAME: *
Library Card Number:  You need a valid Berlin-Peck Memorial Library card so that we can check out the box to you. Please contact the library BEFORE filling out the form if you are a teen who has lost their library card, has fines on their library card OR you are a parent registering for your teen. *
Grade: *
Phone Number: please make sure this is accurate, as this is the number we will call to let you know your Take Out Box is ready to be picked up! *
Email: *
Favorite Book #1: we'll use this information to make sure we select books you love! *
Favorite Book #2: we'll use this information to make sure we select books you love!
Favorite Book #3: we'll use this information to make sure we select books you love!
Favorite genre: *
Is there anything else we should know about what you like to read?
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