HOMEBOUND DELIVERY SERVICE APPLICATION

 

Kelley Library cardholders who love to read and have difficulty visiting the Library due to a

temporary or permanent disability can take advantage of our home delivery service:

Mobile Books. Books and audiobooks are selected based on your reading interests and

requests are delivered to your home on a biweekly basis. We will work with you to

determine a good time for our regular visit. For further information, call 603-898-7064.

Date: ___________________________

Name: _____________________________________________________________

Address: ___________________________________________________________

Telephone number: __________________________________________________

Email address: ______________________________________________________

Library card number: ____________________________________

Emergency contact: __________________________________________________

Emergency contact phone number: _____________________________

How many items would you liked delivered at each visit? ____ Books ___ Audiobooks

Reason for requesting this service: ___________________________________________

________________________________________________________________________

________________________________________________________________________

Please select the format(s) you prefer:

____ Regular Print ____ Large Print ____ Paperback ____Hardback

____ Books on Cassette ____ Books on CD

Please select the type of books you like to read:

___ General fiction ____ Romance ____ Christian fiction ____ Gentle reads

___ Mysteries ____ Cozy mysteries ____ Police procedural ____ Humor mysteries

___ Science Fiction ____ Fantasy ____ Westerns ___ Horror

___ Thrillers ___ Best sellers ____ Classics

List some of your favorite authors: _________________________________________

________________________________________________________________________

________________________________________________________________________

Non-fiction:

___ Cooking ___ Needlework (specify kind: ___________)

___ Crafts/Hobbies (specify kind: _______________) ____ Gardening

___ Biography ___ History (specify period: __________________)

___ New Hampshire topics ____ Politics ____ Business

___ Religious/inspirational ____ Travel ____ Animals and pets

___ War ____ Health ____ Occult ____ Best sellers

Name some books you have enjoyed in the past: _____________________________

_______________________________________________________________________

_______________________________________________________________________

Kelley Library

234 Main St, Salem NH 03079

603-898-7064

www.kelleylibrary.org

© 2016 by Trademark.
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Hours

Mon - Fri 9:00 -8:30

Sat 9-2

Sun Closed

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