Shasta Public Libraries - Book Drops Application
Complete this form to sign up for our 55+ home delivery service.
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Participant Information
Name *
Address *
Phone *
Email *
Are you age 55 or older?
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Emergency Contact Information
Name *
Phone *
Relationship *
Authorized to access library account? *
Program Questions
Do you have a current Library card? *
I am unable to easily come to the Library because of: *
Frequency of Deliveries *
Reading Interests (check all that apply) *
Required
My favorite authors are: *
Formats/Types of Materials (check all that apply) *
Required
Agreement
I understand that I am responsible for materials delivered to me through the home delivery program. *
Required
Submit
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