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2. First Name*
3. Last Name*
5. Email Address*
6. Phone Number
8. Title Detail*

   Author

9. Publisher*
11. ISBN

    ISBN-10 or ISBN-13

12. Date of Publication
    Date of Publication
14. Age Level

    1. Adult
    2. Young Adult
    3. Children
16. Item Format

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    1. Book
    2. Audiobook or CD
    3. eAudiobook
    4. Large Print
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