Books by Mail Application

Garland County Library

1427 Malvern

Hot Springs, Arkansas 71901

(501) 623-4161

 

 

Please Print or Type______________________________________________________

 

Name (Last)________________________(First)______________________(Initial)____

 

Street address____________________________________________________________

 

City_______________________County_____________State__________ZIP_________

 

Telephone  ____________________________________Date of Birth_______________

 

Library card number ______________________________________________________

 

 

Please circle the primary disability preventing you from reading standard printed material or from being able to use the library in person.  The Library may require a letter from a professional to verify your disability/handicap or homebound status.

 

Blindness                                Physical handicap                               Homebound due to
                                                                                                            long-term lack of

                                                                                                                        transportation

                                                                                                                                                           

                                                                                                             

                                                                                                             

Visual handicap                      Homebound due to

                                                polonged illness

                                                                                                                                                                                                                                                                                                                                                                          

Circle A or B

 

A.                Send only the specific titles I will request.

 

A.                I wish to have books, large print books, books on tape or cd, and descriptive videos selected for me.

 

  Please circle all the formats you wish to receive:  Books   Large Print Books   Videos

 

 Audio Books on Cassette        Audio Books on CD

 

Note:  If you wish to have library materials selected for you, the library needs information about your reading, listening and viewing interests.  Please circle

the subjects you prefer or write your interests in the space provided:

 

 

Adventure stories                                  Drama                                      Occult, supernatural

 

Animals, wildlife                                    Family stories                           Philosophy

 

Bible, religion                                        Fantasy                                    Poetry

 

Biographies                                          Folklore                                   Psychology, self-help

 

Business                                               Gardening                                 Romance

 

Career, job training                               Gothic novels                            Science

 

Children’s fiction                                   Government, politics                 Short stories

reading level____

                                                            Historical Fiction                       Sports

 

Other________________________________________________________________

 

      Children’s non-fiction                      History—U.S.                          Spy Stories

      reading level_____

                                                            History---World                       Travel

 

      Classic novels                                 Humor                                      War, war stories

 

      Computers                                     Mysteries                                 Westerns

 

      Cooking                                         Nature

 

 

 

 

 

I certify that after reading the above information I do qualify for the Garland County Library Books by Mail Program.

 

Signature_________________________________________Date___________________