Homebound Services Application

Please fill out the form below to apply for homebound services. If you prefer to print and mail in a paper form, there is a link here. Someone will call you to discuss your eligibility and scheduling of services.  

Is your Emergency Contact authorized to receive information about your library account?
Did you know the library has resources available online? Would you like to learn more?
I am unable to come to the library due to temporary or long-term health, mobility, or disability barriers. *
I understand that I am responsible for all materials checked out on my account and that I will be charged the replacement cost for any materials that are lost or damaged. *
Book Format Preference
Genre Preferences for Books - FICTION
Genre Preferences for Books - NON-FICTION
I would like this many music CDs each month
I would like this many DVDs each month
Music Genre Preferences
Movie Genre Preferences