Name | ||||
Address | ||||
Phone/Email | ||||
Library Card Number | ||||
Preferred Reading Format ( Please Check) | ||||
Audio Books |
Large Print |
Regular Print |
||
Do you want magazines? | Do you want movies? | |||
Day(s) of the week you will be home for pick-up and delivery? Monday Tuesday Wednesday Thursday Friday |
||||
Type of books you are interested in?
|
||||