"Early Ohio" Case History Online Reservation Form

  • To allow for fair distribution of the Case Histories, only one case is permitted at a location at a time.
  • All Case Histories are available on a first request, first reserve basis upon receipt of the emailed or mailed form.
  • Applications will be accepted after August 1st prior to each school year.
  • Each Case History is loaned for a 7-day Monday - Monday period only. Cases will be shipped UPS to arrive by your beginning Monday date - or they may be picked up.
  • Each Case History is to be returned by U.S. Mail, UPS, or in person at the borrower's expense. There will be a late fee of $2.00 for each day the case is tardy.
  • There is a $25.00 processing and handling fee for each case borrowed that must be paid prior to shipment or pick up.
  • We accept cash, check, or credit card for this fee.
  • With completion of this form, I agree to the above terms and conditions.

All fields marked with "REQUIRED" MUST be filled in for the submission to go through. If the "Submit" button is selected without all of the "REQUIRED" fields filled in, ALL of the fields will have to be re-entered.

School/Library: REQUIRED

School or organization street address: REQUIRED

City, State, ZIP: REQUIRED

Phone: REQUIRED

FAX:

Teacher/Librarian Name: REQUIRED

Teacher/Librarian Street Address: REQUIRED

Teacher/Librarian City State ZIP: REQUIRED

Your Email Address: REQUIRED

Number of attending students: REQUIRED

Grade Level: REQUIRED


Case Selected: "Early Ohio"

Requested Date: REQUIRED

Do you want the case shipped? $25
Y N
Will you pick up the case? $25
Y N
Further questions or comments: