****We have the sheets for clients to print off:

MT’s Library: Library Bucks Verification Sheet                

I, ___________________________________________________________________, 

Client Initials:

______I have completed a EWYL video lesson signed with verification by a MT’s Library representative

______I have completed and returned an EWYL homework assignment signed with verification by a MT’s Library   representative

______I have completed a video lesson series signed with verification by a MT’s Library representative

______I have completed a medical, mental, or dentist appointment and got the Contact information and signature below

______My child(ren) has/have completed a medical, mental, or dentist appointment and got the Contact information and have attached the appointment sheet to verify                          

______I have completed the MT’s Library Well-Child Visit 1st year Booklet for a new baby 

______I have completed a WIC appointment and have attached the appointment sheet to verify                          

______I have attended a La Leche League meeting and got the Leader's Contact information and signature below.

______I have attended a Recovery Meeting (NA, AA, CR, AL-Anon, SA, OEA, etc) and got the leader's contact information and  signature below

______I have attended a church service/event and attached the flyer to verify 

______I attended a class/workshop at MT’s Library and got the Contact information and signature below

______I have completed a workshop series at MT’s Library and got the Contact information and signature below

______I attended a class/workshop at another agency and got the Contact information and signature below

______I have completed a educational series at another agency and got the Contact information and signature below

______I have presented a Transcript for Library Bucks for good grades from a local Educational Institution/homeschool teacher for verification

______My child(ren) has/have presented a report card for Library Bucks for good grades

______I participated in an exercise class/program at MT’s Library and got the Contact information and signature below

______I participated in an exercise class/program at another agency and got the Contact information and signature below

______I participated in a sports related class/activity at MT’s Library and got the Contact information and signature below

______I participated in a sports related class/activity at another agency and got the Contact information and signature below

______I completed a job application and provided printed proof for verification

______I completed a job interview and got the Contact information and signature below

Date: _______________________________________________________________________

Agency Contact Name and #: _____________________________________________________________________________

Client Name: _____________________________________________________________________________

Verified by Library Rep: __________________________________________________________________________________

Bucks earned:______________

For each verification MT’s Library Bucks will provide: 

Academics: $3 for each A, $2 for each B, $1 for each C, $.50 for each D

Educational class/workshop/lesson:$1  each or $5 for a completed series

Exercise/Sports: $1 each session

Health appointments/support group: $1 each appointment

Literary: completed Reading Logs--$.25 each verified book read by child and $1 each verified book read by an adult