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Homebound Delivery Application

2. The Watertown Free Public Library’s Special Delivery Homebound Service provides library materials to residents who live within Watertown and cannot come to the library. This service is provided free of charge. Delivery is on Wednesdays.
   
   To apply, fill out the form and Submit. Someone will be in touch with you within a couple of days to set up an interview and talk about your options for book selections. Please note: you must have a library card in order to join this program.

4. First Name*

5. Last Name*

7. Address*

9. City*

10. State*

11. Zip Code*

13. Phone Number

14. Email Address

16. Library Card Number*

18. Please Specify Your Reading Preferences*

    1. Book on Cassette
    2. Book on CD
    3. DVD
    4. Large Print
    5. Paperback
    6. Playaway
    7. Standard Print
    8. VHS

19. Interests*

    1. Arts & Crafts
    2. Biography
    3. Business
    4. Cooking
    5. Foreign Languages
    6. Health
    7. History
    8. Historical Fiction
    9. Humor
    10. Music
    11. Mystery
    12. Novels
    13. Poetry
    14. Religion
    15. Romance
    16. Sci-Fi/Fantasy
    17. Science/Math
    18. Sports
    19. Travel
    20. Other

21. Foreign Languages

    1. Spanish
    2. Russian
    3. Chinese
    4. Other

22. Please specify language.

23. Please specify other interest.

Leave This Blank:


25. 1. Receive an email copy of this form.
26. Email address

    This field is not part of the form submission.

27. Submit

* indicates a required field