CLSE Lunar/Asteroid Traveling Exhibit Request

Request for the Loan of a Specific Exhibit

After we receive your request, we will respond within 10 business days. We will later send you the link to the online loan agreement within 1-2 months before the period of the loan. Please fill it out within 10 business days of receiving the email request from us.

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Contact Information
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About the Exhibit
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Alternate Contact
Please provide an alternate contact, in the event that you are away when we ask you to fill out the online loan agreement.
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Location Exhibit will be Displayed
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Other Information
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Library
Science Center
Planetarium
Museum
Other. Please describe:  
* Please estimate your audience diversity:
*How would you classify your community?
*How would you classify the community income level?
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I will provide credit card information in the online loan agreement that will be charged $100 to help cover shipping costs.
I will provide my organizations FedEx account information for LPI to use to ship the exhibit to me. I understand that LPI cannot estimate what my shipping charges will be.
I will pick up and return the exhibit in person.
My organization is financially unable to support the shipping costs for this loan request.
    Please provide additional information regarding your need:
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the Explore! library program
Museum Alliance
email from colleague
other (please describe)



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 I have read and agree to the Loan Guidelines


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If you see an error message, please correct and resubmit.