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4. Name*
5. Library Card Number*
7. Email Address*
8. Phone Number
10. Problem / Issue Needing Resolution*
12. Device (Please Check Only One)

    1. Android Phone
    2. Android Tablet
    3. Chromebooks
    4. iPad or iPod

    1. iPhone
    2. Kindle and Kindle Fire
    3. Kobo
    4. Mac

    1. MP3 Player
    2. Nook
    3. Windows
    4. Other eReader Device
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