Books By Mail

Patron Registration Form

Name: ______________________________________________________________________________

Address: ____________________________________________________________________________

City:  __________________ State:  Michigan    Zip: ______________ Phone:____________________

Email: ______________________________        Date of Birth: ________________________________

Library Barcode: ______________________________________________________________________  

Please provide us with a personal contact in the event we are unable to reach you:

Name: ________________________________________________________________________________

Phone: ________________________________     Relationship to you: ___________________________

Patron Preferences

1.  Preferred Formats (check all that apply):

___ Large Print       ___ Standard Print      ___ Paperback      ___ Audio books CD

___ Audio books cassette      ___ No preference       ___ Other: _______________

2.  Type of books desired (check all that apply):

Fiction

___ Adventure

___ Fantasy

___ General

___ Historical

___ Inspirational

___ Mystery

___ Romance

___ Science Fiction

___ Suspense

___ Western

___ Other _________________

Non Fiction

___ Biography

             ___ Any type

             ___ Celebrity

             ___ Historical

             ___ Political

___ Culinary

___ Health

             Topic _________________

___ History

___ Poetry

___ Religion

___ Travel

___ Other ___________________

Please notify the library if any information on this form changes

 231 834-5713