| *Name: | |
| *Email: | |
| *Phone Number: | |
| *How should we contact you? | Phone Email |
*What is a convenient day and time to reach you? (Staff is available Tuesday-Saturday during library hours.) | |
| *Filling this out for youth? | Yes No |
| If yes, please provide: | Name: Age: Reading level: School grade: |
| *What books/authors have you recently enjoyed? | |
*Is there a particular genre you enjoy reading? (examples: mystery, fantasy, or nonfiction) | |
| What do you like to do in your spare time? What are your hobbies? | |
| Provide additional information that is helpful for the selection process. | |
| *Do you prefer large print text or regular print text? | Large Regular |