Applicant Information
Name
*
*
Address
*
*
*
*
*
Do you have a library card?
Do you give permission for the library to keep a record of the materials sent to you?(If you wish the staff to select materials for you and to avoid duplication, this is necessary.)
Do you require books in large print or on audio?
Alternate Contact
Name
*
*
*
Statement of Eligibility

I understand that I am responsible for any damage or loss of material. If the applicant is under 18, a parent or guardian must also sign indicating willingness to accept responsibility.

*
Book Selection Information
The staff will send specific titles you request, if available, or can choose books and other materials for you. If you wish to have books selected for you, the library needs information about your reading interests.
Please check below the types of books/materials you prefer:
Books
Other

*Large print/audio users will be sent materials under the U.S. Postal Service's "Free Matter for the Blind and Handicapped" program. No postage is required in mailing the library's large print books or audio cassettes.

Please specify your preferred authors or artists:
Check as many of these categories/interests as you wish:
Nonfiction
Fiction