Name: * Address: * Telephone Number (10 digits required): * Email: * Library Card Number: * In order to qualify for this service you must be one of the following: * Live further than 10 kilometers away from one of our branch libraries Are physically unable to visit a branch If under the age of 14, please provide: Parent/Caregiver Name: Parent/Caregiver Telephone Number (10 digits required): Is your Mailbox: * Large Medium Small Tell us about your mailbox: * Approximately how many kilometers do you live from one of our libraries? * What type of book is easiest for you to handle? * How often do you pick up your mail? * How often and how many items do you wish to have mailed to you? For example: 3 items every 2 weeks * Will you be choosing your own titles? * Yes No Would you like to be sent update booklists? * Yes No If yes, please indicate which booklists you would like to receive: Audiobooks DVDs Fiction Large Print Nonfiction Would you like us to contact you by: * Email Mail Phone Our staff will be contacting you to finalize the registration. Thank you. Submit
