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Beyond the Walls Outreach Service - Patron Information
Registration form for Beyond the Walls (Delivery service for the homebound)
First Name *
Your answer
Last Name *
Your answer
Physical Address *
Your answer
Mailing address (if different than Physical Address)
Your answer
Phone Number
Your answer
Email Address
Your answer
Is this request temporary or permanent?
Library card number (if you have one)
Your answer
Fiction Genres
Non-Fiction Genres
DVDs
Who are your favorite authors?
Your answer
What are some titles you have really enjoyed?
Your answer
Do you need large print
Do you object to sexual content, violence, or foul language? (we cannot guarantee you won't receive material with these if you check yes, since we have not read every book, but we will do our best)
Do you have internet Access?
Would you like to check out magazines?
Are you interested in Audio books on CD?
Are you interested in using an e-reader device?
Do you prefer morning or afternoon deliver? (We will do our best to accommodate your preference but there is no guarantee for delivery time)
Designated Person(s) to Pick up materials on your behalf
Your answer
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