Registration Form

Name:_________________________________

Address:_______________________________

Email:_________________________________

Phone:________________________________

Library Card Number:____________________

Please Specify Your Book Preferences: (select all that apply)
[ ]     Large Type
[ ]     Standard Print
[ ]     Paperback
[ ]     Hard Cover

Please Specify Your Subject Preferences:
[ ]     Biography
[ ]     Fantasy
[ ]     History
[ ]     Historical Fiction
[ ]     Science Fiction
[ ]     Mystery
[ ]     Short Stories
[ ]     Romance
[ ]     Novels
[ ]     Non-Fiction Subjects: _______________________________

We also offer:
[ ]     Video/ DVD Feature Films
[ ]     Music CDs/ Cassettes
[ ]     Non-Fiction Videos/ DVDs
[ ]     Books on Tape or CD
[ ]     Magazines (non-current issue)

We are always happy to to make recommendations.