[Logo] Highlands Regional Library Cooperative
MONTHLY DELIVERY STATISTICAL FORM
For Use within the Library ONLY! - Please do NOT send this form to the Regional Office

 LIBRARY:  
 SCHOOL DISTRICT:    MONTH:
DATE DRIVER'S INITIALS # PACKAGES SENT
WITHIN THE REGION		 # PACKAGES SENT
OUTSIDE THE REGION
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31      
TOTALS è è è    

For Use within the Library ONLY! - Please do NOT send this form to the Regional Office
Please record these figures on the QUARTERLY DELIVERY STATISTICAL FORM