Spaghetti Book Club
Library Registration Form

Please complete all three sections of this form.

1.) LIBRARY INFORMATION:
Please complete section A or B

A. If your library is already part of the Spaghetti Book Club, please select your library from the list below, then skip to section 2.

B. If your library is joining for the first time, please complete the rest of section 1.

Name of Library:

Address:

City:

State:

Zip Code:

Country:

Library Phone #:

Library Director's Name:

Does your library have a web site? Yes     No

Would you like us to link your group's page to your library's web site? Yes     No

What is the url of your library's web site?

2.) GROUP INFORMATION:

Your first name:

Your last name:

Select one: Mrs.    Ms.    Miss    Mr.   

Your title:

Your direct telephone #:

Name you are referred to by your students:

Your email address:

Grade(s): thru (if appropriate)

Number of students in your group:

Group home page color:
Green Light Blue
Orange Peach
Pink Purple
White Yellow

3.) MEMBERSHIP INFORMATION:

Please select the membership package you are registering for:

I am a returning member.

Username: Please select a username between 4-10 characters long.

Password: Please select a password between 4-10 characters long.

How did you hear about the Spaghetti Book Club? (Please mention the specific person, book, article, web site or email list, if appropriate).