Home Delivery Service Application

Eligibility Criteria *

Chronic illness

No transportation

Physical disability

Visual impairment

Other

Special Instructions *

Check ALL that apply to you

I read ONLY Large Print

I prefer Large Print but will accept Regular Print to fill my title requests

I read Regular Print

I can't hold heavy books

I want ONLY Audio Books

What formats do you prefer *

Large Print

Regular Print

Paperback Regular Print

Audiobook - CD

Audiobook - Playaway

Movie - DVD

Movie - Blu-ray

Music CD

Magazine

What genres do you prefer? *

Fiction

Nonfiction

Both

Fiction I am interested in... *

African American

Fantasy

Historical

Inspirational

LGBTQIA+

Literary

General Mystery

Cozy Mystery

Romance

Science Fiction

Thriller

Western

Woman's Fiction

Nonfiction I am interested in... *

Animals and Pets

Art

Biography

Business

Food

History

Humor

Journalism

Nature

Health

Poetry

Politics

Science

Sports

Self-Help

Spiritual Wisdom

Technology

Travel

True Adventure

True Crime

The kind of movie or TV show I am looking for... *

Action

Animation

Comedy

Drama

Experimental

Fantasy

Historical

Horror

Musicals

Romance

Science Fiction

Thriller

Westerns

Magazines I like to read...

Animals

Crafts

Food & Crafting

Home & Style

News

Pop Culture/Entertainment

Science

Sports

Woman's Fiction

Music I enjoy...

Blues

Classical

Country

Dance

Easy Listening

Folk

Hip-Hop/Rap

Holiday

Jazz

New Age

Opera

Pop

R&B/Soul

Reggae

Rock

Soundtrack

World

Other

Things I want to avoid...

Addiction

Death

Disease

Explicit Sexual Content

Gore

Politics

Religion

Rough/Obscene Language

Sexual Themes

Violence

War