Homebound sign-up insert

Full Name: Birth Date: (___________/___________/________________) Library Barcode #: Email Address: Delivery Address: Phone Number: Preferred Method of Communication (check one): □ I will need to apply for a Library card. The Louisville Public Library is starting a new, FREE service delivering Library materials to your home. Fill out this form to apply for yourself or a family member. Homebound Delivery Request* □ Phone call at above number □ Text message at above number □ Email at above address *This service has not yet started. A library staff member will be in contact with you in the near future. Forms may be mailed to: The Louisville Public Library, 700 Lincoln Avenue, Louisville, Ohio 44641 or dropped in the book drop. Due to COVID-19, Library staff will coordinate deliveries to drop materials at your front door. No Library staff will enter your home. MONTH DAY YEAR

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