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Markleeville, CA (530) 694-2120 Bear Valley, CA (209) 753-6219 Alpine County Library 3D Print Request Form Patron Name (First & Last) Request Telephone Number Library Card Number Email Address Print Project Filament Filament Print speed/detail NOTES Amount paid Staff By signing this form, I agree under oath to adhere to all the policies and procedures set forth in the Alpine County Library 3D Printing Policy. I further agree that my projects are not duplicating intellectual property belonging to another and that I am not reproducing copyright material without permission. Patron /Parent Signature Date of (completed by staff) Alpine County Library 3D Printing Policy SIGN SIGN