Initiation Form

Please fill in the fields below and click the Submit button. Or, if you prefer, print this page, fill it in, and fax or mail to: Library Technologies, Inc., 2300 Computer Ave., Suite D-19, Willow Grove, PA 19090 (Fax: 215-830-9422)

Fields marked with an asterisk (*) are required.

*Name of library:
*Mailing address:
*City: *State/
Province:		 *Zip or
Postal Code:
*Contact name: *Phone:
*Email: Fax:
Billing:
  • *Send invoices to attention of:
  • Open purchase order # (if necessary):
1. The library:
  • *plans to begin submitting files (month and year):
  • *will probably submit files:
 dailyweeklymonthlyother
  • *will submit about this many
    records each month:
2. Current rates for Authority Express are:
  • $10 per file submitted for processing
  • 10¢ per record processed
3. The library understands (i) that it will be billed at the end of each month for use of Authority Express during that month and (i) that invoices will be due "net 30 days."
4. Upon receipt of this form, LTI will assign an account identifier and password to the library and send profiling information to the library.