"Application Form for Free Library Service: Adults" - New York

Application Form for Free Library Service: Adults is a legal document that was released by the New York State Education Department - a government authority operating within New York.

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New York State Talking Book and Braille Library
Application Form for Free Library Service: Adults
You can complete this form and save it as a Word document, or you can print the
form and fill it out entirely. Completed forms can be emailed, faxed or printed and
mailed. We accept electronic certification instead of a handwritten signature,
including full legal name; title/position; organization name; complete mailing
address; email address; telephone number; date.
Applicant Information (Please Print or Type)
For children under 18 years of age, please use the children and teens application.
First Name:
Middle Name:
Last Name:
Gender:
Date of Birth:
Veteran. By law, preference in lending books and equipment is given to
veterans. Please check here if you have been honorably discharged from
the U.S. armed forces.
Address:
City:
State:
Zip Code:
Telephone:
Email Address:
Name of your local public library and county:
1
New York State Talking Book and Braille Library
Application Form for Free Library Service: Adults
You can complete this form and save it as a Word document, or you can print the
form and fill it out entirely. Completed forms can be emailed, faxed or printed and
mailed. We accept electronic certification instead of a handwritten signature,
including full legal name; title/position; organization name; complete mailing
address; email address; telephone number; date.
Applicant Information (Please Print or Type)
For children under 18 years of age, please use the children and teens application.
First Name:
Middle Name:
Last Name:
Gender:
Date of Birth:
Veteran. By law, preference in lending books and equipment is given to
veterans. Please check here if you have been honorably discharged from
the U.S. armed forces.
Address:
City:
State:
Zip Code:
Telephone:
Email Address:
Name of your local public library and county:
1
Alternate Contact. Please give the name and address of a contact person.
Contact Name:
Relationship:
Contact Address:
Contact Phone:
Contact Email:
Eligibility for Library Service
Check the primary disability that prevents you from reading standard printed
material:
Blindness
Visual Impairment
Physical Disability
Deaf-Blindness
Reading Disability
Notice: Records relating to recipients of Library of Congress reading materials
are confidential and will not be disclosed without the consent of the individual.
(New York State Civil Practice Law and Rules, Section 4509, 1982, 1988).
Service Requested
Digital talking book player
Spanish-language player
Audio books (available via download or U.S. Mail)
Braille books (available via download or U.S. Mail)
Magazines (available via download or U.S. Mail) We will send you a list of
available audio and braille titles.
The digital talking book player is supplied to eligible persons on extended loan.
This player must be used with recorded reading material provided by the Library
of Congress and its cooperating libraries, or it must be returned to the issuing
library. Please return all books promptly so that they are available for other
patrons.
2
Service Options
Audio books can either be downloaded or obtained in digital cartridge format from
the NYS Talking Book and Braille Library via US Mail. Please read this
information carefully and select Option 1, Option 2 and/or Option 3 below. You
may use all three options simultaneously.
Option 1. I would like to download the books myself.
BARD (Braille and Audio Reading Download) enables patrons or their helpers to
use their computer to download any title to a flash drive or a blank digital cartridge
that can then be played on the digital player that you will receive when your
service starts. BARD also allows you to use your iOS or Android mobile device to
download and listen to the books. Every title in the collection is always
immediately available to you when you use BARD. We provide phone support for
downloading. If downloading is not feasible for you, choose either Option 2 or
Option 3.
Option 2. I would like to request specific titles myself.
You will only receive the titles that you request. Request and reserve books using
the online catalog, contact us directly by phone or email, or mail us a list of the
titles you want. New and popular titles often entail a long wait time since many
other members will request them at the same time.
Option 3. I would like to choose subjects I'm interested in.
Choose your reading interests from the lists on the next page. The TBBL software
program will then find books in these subjects and send them to you via US Mail.
Note that if you check this option, you still may request specific titles as described
in Option 2. You can also list the names of authors whose books you would like us
to send. Please select your reading interests from the following list.
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Fiction:
Adventure
Humor
American
Mystery
Bestsellers
Religious Fiction
British
Romance
Classics
Science Fiction
Crime
Short Stories
Drama
Supernatural and Horror
Family
Suspense
Fantasy
War
Gothic
Westerns
Historical
Young Adult
Nonfiction:
Adventure
Psychology and Self Help
Animals and Wildlife
Religion
Bestsellers
Science and Technology
Biography and Memoir
Social Sciences
Business and Economics
Sports
Government and Politics
Travel
Health and Medicine
True Crime
Legal Issues
U.S History
Music and Music History
War and Military
Philosophy
World History and Affairs
Poetry
4
Will you accept:
Books containing strong language?
No
Some
Yes
Books containing explicit sex?
No
Some
Yes
Books containing violence?
No
Some
Yes
List any other reading interests, including authors and titles:
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