Name: * Address: * Postal Code: * Telephone Number (10 digits required): * Email: Library Card Number: * (If you do not already have a library card, you may get one at any of our branches or online. There is no charge.) Contact Person (optional) Name: Telephone Number (10 digits required): Email: Eligibility (reason why you are unable to use print materials): * severe or total impairment of sight or the inability to focus or move one's eyes the inability to hold or manipulate a book an impairment relating to comprehension temporary disability of one of the above, ex. Eye surgery (please describe how the disability prevents you from using print materials) * Upon receipt of this application you will be contacted by our staff to discuss method of service delivery, selection preferences and any other needed details. Submit
