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http://www.waukeganpl.org
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Home Delivery Service Application
Library Card Number:
Full Name:
*
Address:
*
Email:
Phone:
*
Alternate Contact Name:
Alternate Contact Phone:
Health condition that makes home delivery service nesessary:
Format of printed material desired:
Regular print books
Large print books
Paperbacks
Magazines
Format of audio material desired:
Audio book on CD
Christian CD
Classical CD
Country CD
Opera CD
Popular CD
Jazz or Blues CD
Show tunes CD
Fiction Reading Preferences:
General Fiction
Adventure
Science Fiction/Fantasy
Mystery
Short Stories
Westerns
Humor
Historical Romance
Contemporary Romance
Paranormal Romance
Christian Romance
Suspense Romance
Non-Fiction Reading Preferences:
Arts
Biography
Computers
Cooking
Crafts/Decorating
Crime
Gardening
Health
History
Nature
New Age
Poetry
Politics
Psychology
Religion
Science
Sports
Travel
Please list your favorite authors/artists:
Special Requests:
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Mollom privacy policy
.
Source URL:
http://www.waukeganpl.org/form/home-delivery-service-application
