Alternative Service Application Form

"*" indicates required fields

First Name*

Last Name*

Address*

Street Address Address Line 2 City Postal Code

Telephone Number*

Email Address*

Library Card Number (14 digits required)*

If you do not already have a library card, you may get one at any of our branches or online. There is no charge.

Contact Person (optional)

First Name

Last Name

Telephone Number*

Email Address*

Eligibility (reason why you are unable to use print materials)*

severe or total impairment of sight or the inability to focus or move one's eyes

the inability to hold or manipulate a book

an impairment relating to comprehension

temporary disability of one of the above, ex. Eye surgery

Please describe how the disability prevents you from using print materials*

Upon receipt of this application you will be contacted by our staff to discuss method of service delivery, selection preferences and any other needed details.

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