Burlington Public Library
210 Court Street · Burlington, IA 52601 · 319-753-1647
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Assignment Alert Form

As part of the Partners in Education initiative, Burlington Public Library is asking teachers to alert us of upcoming assignments so that we can better serve the students of this community. To give the staff time to prepare, please send this form one week in advance. Staff may call with questions about your request.

Teacher: 

School: 

Work Phone: 

E-mail:

Number of students involved: 

Date assignment will be given:  

Date assignment will be due: 

Brief Description of the assignment:

What specific sources do you have in mind for students to use for this assignment:

Are there sources that students are NOT to use when completing this assignment:

Is this an annual assignment:
Yes
No

The information you have provided will help us to serve your students in an efficient, timely manner. It will also be used to assist us in making purchasing decisions for the collection. Thank you for completing this form.

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Updated: 03/09