Individual Delivery Request Form
To request deliveries of library materials, please fill this form and submit. An Eckhart Public Library staff member will be in contact with you as soon as possible.
* Required
Name
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Your answer
Phone Number
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Your answer
Email Address
Your answer
Address
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Your answer
How will be receiving Eckhart Mobile Outreach Delivery Services?
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As a resident of a senior living facility or nursing home
In my home
How long to you expect to need this service?
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Indefinitely
Short term
Seasonally (winter deliveries run from November to May)
If you only need this service short term, please provide dates below.
Your answer
What are your favorite books, authors and series?
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Your answer
What are some of your favorite movies, TV shows and genres?
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Your answer
What are some of your hobbies, interests and skills?
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Your answer
What are some books, authors, genres, movies and TV shows that you do NOT like?
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Your answer
Is there anything else you DO NOT like?
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Your answer
What kinds of materials would you like to receive? Check all that apply.
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Books
Audiobooks (limit 10)
DVDs (limit 10)
CDs
Vinyl Records
Magazines
Teen/YA materials
Graphic novels
Board games
Puzzles
Children's chapter books
Children's picture books
Children's early readers
Children's board books
Children's DVDs
Children's kits
Children's VOX books (books that read aloud)
Other:
Required
How many of each item would you like to receive? (Example: 3 books, 2 DVDs, 1 graphic novel)
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Your answer
Which book formats do you prefer? Check all that apply.
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Large print
Standard print
Hardback
Paperback
Braille Books
Required
Which FICTION genres do you enjoy? Check all that apply.
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Adventure
Classics
Drama
Fantasy
Historical
Horror
Inspirational
Literary
Mystery
Romance
Science Fiction
Short Stories
Suspense/Thriller
Western
I don't want to receive fiction.
Other:
Required
To help us better select fiction materials for you, please indicate what appeals to you when it comes to CHARACTERS. Check all that apply. (Optional)
Believeable
Brooding
Complex
Courageous
Diverse
Flawed
Good
Likeable
Quirky
Relatable
Sassy
Spirited
Strong females
Sympathetic
Unlikeable
Unreliable
Well-developed
Other:
To help us better select fiction materials for you, please indicate your STORY preferences. Check all that apply. (Optional)
Action-packed
Character-focused
Compelling
Concise
Conversational
Descriptive
Detailed
Easy to understand
Engaging
Fast paced
Gritty
Intricately plotted
Leisurely paced
Lush
Lyrical
Mysterious
Plot-driven
Realistic
Spare
Thrilling
Witty
Other:
To help us better select fiction materials for you, please indicate what appeals to you when it comes to the TONE of the story. Check all that apply. (Optional)
Amusing
Bittersweet
Bleak
Creepy
Dramatic
Emotional
Feel-good
Funny
Haunting
Heartwarming
Heart-wrenching
Homespun
Hopeful
Impassioned
Inspiring
Moody
Moving
Mystical
Nostalgic
Quiet
Racy
Romantic
Sad
Suspenseful
Which NON-FICTION subjects do you enjoy? Check all that apply.
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Biography/Memoir
Business/Economics
Career
Computers/Tech
Cooking/Food
Education
Fine Arts
Folklore/Supernatural
Gardening
Health/Medical
History
Humor
Languages
Poetry
Politics/Current Events
Religion/Philosophy
Science/Nature
Sports/Leisure
Travel/Adventure
True Crime
I don't want to receive non-fiction.
Other:
Required
Which DVD genres do you enjoy? Check all that apply.
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Animated cartoons
Anime
Children's movies
Classics
Comedy
Documentary
Drama
Family
Fantasy
Historical
Horror
Inspirational
Romance
Science Fiction
TV Comedy
TV Drama
I don't want to receive DVDs.
Other:
Required
What are your movie ratings preferences? Check all that apply.
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G
PG
PG-13
R
NR
N/A
Required
Which magazine categories do you enjoy?
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Business
Cars
Crafts
Entertainment
Family
Food
Health/Wellness
History
Home
Music
News
Science/Tech
Sports
Travel
I don't want to receive magazines.
Other:
Required
Which music genres do you enjoy?
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American Folk
Choral
Christian
Classica/Opera
Comedy
Country
International
Jazz/Blues
Musicals
Pop
Rock (Classic)
Rock (Contemorary)
Soundtracks
I don't want to receive CDs or records.
Other:
Required
We have recently started our Library of Things, a collection of short term use items available for checkout. For example, a KitchenAid mixer, cake pans and fishing poles. Would you like more information about this?
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Yes
No
Please list anything else you may interested in that we didn't mention.
Your answer
Do you have any special delivery instructions?
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Your answer
Eckhart Public Library staff selects materials based on patrons’ needs and requests. Eckhart Public Library staff are not responsible for the content of materials that may be offensive or disturbing to individual patrons. Requesting certain materials does not guarantee they will be in the collection. The library may maintain checkout history records to improve library service. This information is confidential and for library use only.
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