To be completed by staff of hospitals, nursing homes, schools, etc. I am a staff member of a facility offering programs for person with a print disability as defined in section 32 (I) of the Canadian Copyright Act, and I declare that these alternative materials borrowed on this card will be made available only to clients with a print disability. Name: * Title: * Facility: * 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.) 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
