Johnson Public Library Books by Mail Application

The Johnson Public Library is pleased to provide a free Books by Mail service to Hackensack residents who are homebound or have a disability. Books are sent to patrons in a reusable book bag that contains return postage and label. When the books arrive back at the library, another bag with more books will be mailed.

Patrons who are homebound or have a visual or physical impairment that prevents them from handling conventional books can complete this form and return it to the Johnson Public Library. If you have any questions, please contact us at bbm@johnsonlib.org or (201) 343-4781.

Sign in to Google to save your progress. Learn more
Name (Last, First) *
Full Street Address *
Please include the apartment number if applicable. All addresses must be in Hackensack, NJ
Phone Number *
Email Address
Contact Person *
Please include an emergency contact's name and phone number.
Formats *
What kind of materials would you like to receive? *
If you would like to list specific authors, use the "Other" option at the bottom.
Required
Please email signed medical verification forms to bbm@johnsonlib.org.
The medical verification form can be downloaded at johnsonlib.org/bbm
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Bergen County Cooperative Library System.

Does this form look suspicious? Report