Outreach Service Application

2. Outreach Services
   <p>If you live in the township of Waterford and you are restricted to your home permanently or temporarily due to low vision or limited mobility, you may be able to use the Waterford Township Library Outreach Services Program.</p> <p><strong>Frequently Asked Questions</strong></p> <p><em>How often are materials delivered?</em><br /> Library materials can be delivered on an “as needed” basis and you can specify the items you want or let us surprise you!</p> <p><em>Is there any charge for this service?</em><br />No. This service is provided free to the residents of Waterford Township.</p> <p><em>How do I register for this program?</em><br />Complete the service application and library staff will contact you.</p> <p>Alternatively, you can call Jean Hansen at 248-618-7682 to register.</p>

   If you live in the township of Waterford and you are restricted to your home permanently or temporarily due to low vision or limited mobility, you may be able to use the Waterford Township Library Outreach Services Program.

   Frequently Asked Questions

   How often are materials delivered?
   Library materials can be delivered on an “as needed” basis and you can specify the items you want or let us surprise you!

   Is there any charge for this service?
   No. This service is provided free to the residents of Waterford Township.

   How do I register for this program?
   Complete the service application and library staff will contact you.

   Alternatively, you can call Jean Hansen at 248-618-7682 to register.

4. Name*

6. Address*

8. Phone Number*

9. Email Address

10. Library Card Number*

    Enter your Library Card number. Enter "No Card" if you do not have a card at this time.

12. Residence*

    Is this address a senior residence or nursing home?

    1. Yes
    2. No
13. Name of Residence

    If yes, please name

15. Reason for requesting homebound service*

    Please describe your reason for requesting homebound services.

17. Large Print*

    Do you require books in large print?

    1. Yes
    2. No
18. Regular Print*

    If the title you request is not available in large print, will you accept regular print?

    1. Yes
    2. No
20. How many items do you want to have delivered at one time?

21. Books

22. Audio Books

23. Other

25. Reading Interests

    Who are you favorite authors and what types of books are you interested in reading?

Leave This Blank:


27. 1. Receive an email copy of this form.
28. Email address

    This field is not part of the form submission.

29. Submit

* indicates a required field