Homebound Application

Books by Mail Application

Name

Address

Address 2

City

Zip

Phone Number

Library Card Number

Requirements (Check to Agree)

I am resident of the Blanchard Community Library service area and generally confined to my residence either temporarily, due to illness or accident, or permanently, due to age, disability or other mobility problem.

I understand that Homebound Delivery services is limited to 2 packages of no more than 10 items per month, that the checkout period will be 6 weeks, and that standard renewal limits and periods apply.

I understand that I am responsible for the return of materials to the Library, either by return mail or other means.

I understand that the Library does not charge overdue fines, but that standard lost or replacement fees apply to materials I receive through this Homebound Delivery service.

I understand that delivery is limited to physical books, audiobooks, music CDs, DVDs, and blu-ray discs.

Optional

I would like to authorize a designated user to be able to receive information on items checked out to my account or borrow items on my behalf.

Designated User

Library Card Number

Phone Number

Email Address

By submitting this form, I certify that the information provided is true and accurate.

Books by Mail Application

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