Name: Business Name: Telephone Number: Fax Number: E-mail ...

Name:
Business Name:
Telephone Number:
Fax Number:
E-mail Address:
Additional Information:
Date request submitted:
Please indicate on the next page the artwork you would like to
reserve and which loan period you would like it for. The
current loan periods are:
• 1st loan period - week commencing 30/11/09 - 08/05/10
• 2nd loan period - week commencing 21/05/10 - 12/11/10
• 3rd loan period - week commencing 29/11/10 - 07/05/11
Please return to: Andrea Hazlehurst, The Castle Secondary School, Park
Road, Thornbury, South Gloucestershire BS35 1HT
Fax number: 01454 862101

Artwork
Reserve
(please tick)
Loan Period
(please circle or
highlight)
Artwork
Reserve
(please tick)
Loan Period
(please circle or
highlight)
001 1 2 3 4 041 1 2 3 4
002 1 2 3 4 042 1 2 3 4
003 1 2 3 4 043 1 2 3 4
004 1 2 3 4 044 1 2 3 4
005 1 2 3 4 045 1 2 3 4
006 1 2 3 4 046 1 2 3 4
007 1 2 3 4 047 1 2 3 4
008 1 2 3 4 048 1 2 3 4
009 1 2 3 4 049 1 2 3 4
010 1 2 3 4 050 1 2 3 4
011 1 2 3 4 051 1 2 3 4
012 1 2 3 4 052 1 2 3 4
013 1 2 3 4 053 1 2 3 4
014 1 2 3 4 054 1 2 3 4
015 1 2 3 4 055 1 2 3 4
016 1 2 3 4 056 1 2 3 4
017 1 2 3 4 057 1 2 3 4
018 1 2 3 4 058 1 2 3 4
019 1 2 3 4 059 1 2 3 4
020 1 2 3 4 060 1 2 3 4
021 1 2 3 4 061 1 2 3 4
022 1 2 3 4 062 1 2 3 4
023 1 2 3 4 063 1 2 3 4
024 1 2 3 4 064 1 2 3 4
025 1 2 3 4 065 1 2 3 4
026 1 2 3 4 066 1 2 3 4
027 1 2 3 4 067 1 2 3 4
028 1 2 3 4 068 1 2 3 4
029 1 2 3 4 069 1 2 3 4
030 1 2 3 4 070 1 2 3 4
031 1 2 3 4 071 1 2 3 4
032 1 2 3 4 072 1 2 3 4
033 1 2 3 4 073 1 2 3 4
034 1 2 3 4 074 1 2 3 4
035 1 2 3 4 075 1 2 3 4
036 1 2 3 4 076 1 2 3 4
037 1 2 3 4 077 1 2 3 4
038 1 2 3 4 078 1 2 3 4
039 1 2 3 4 079 1 2 3 4
040 1 2 3 4 080 1 2 3 4
Please return to: Andrea Hazlehurst, The Castle Secondary School, Park
Road, Thornbury, South Gloucestershire BS35 1HT
Fax number: 01454 862101

Artwork
Reserve
(please tick)
Loan Period
(please circle or
highlight)
Artwork
Reserve
(please tick)
Loan Period
(please circle or
highlight)
081 1 2 3 4 091 1 2 3 4
082 1 2 3 4 092 1 2 3 4
083 1 2 3 4 093 1 2 3 4
084 1 2 3 4 094 1 2 3 4
085 1 2 3 4 095 1 2 3 4
086 1 2 3 4 096 1 2 3 4
087 1 2 3 4 097 1 2 3 4
088 1 2 3 4 098 1 2 3 4
089 1 2 3 4 099 1 2 3 4
090 1 2 3 4 100 1 2 3 4
Please return to: Andrea Hazlehurst, The Castle Secondary School, Park
Road, Thornbury, South Gloucestershire BS35 1HT
Fax number: 01454 862101