Visiting Library Service - Participant Application

Visiting Library Service provides library materials to Whitby residents who cannot visit the Library due to illness, disability, or other circumstances. Items are selected by staff and delivered by a volunteer on a regular schedule.

Eligibility criteria does apply. For more information, call (905) 668-6531 ext 2010, or complete our Visiting Library Services Application Form below.

Participant Application

Applicant Name

Applicant Library Card Number

Applicant Street Address

Room #

City

Postal Code

Applicant Phone Number

Applicant E-mail

Emergency Contact Information

First Name

Last Name

Emergency Contact Phone Number

Emergency Contact E-mail

Emergency Contact Relationship to Applicant

Would you like to receive materials in languages other than English?

Are you applying on behalf of a family member/friend?

Your name

Relationship to applicant

Phone Number

Do you have a family member or friend available to pickup and deliver library materials to you?

Yes

Reading Preferences

How many items would you typically read or watch in a four (4) week period?

What type of materials would you like to receive? (check all that apply)

Hardcover Books

Paperback Books

Large Print

Audiobooks/Books on CD

DVDs

Blu-Rays

Music CDs

What types of books/movies do you prefer? Feel free to add to this list.

General Fiction

Mystery

Thriller

Historical

Adventure

Science Fiction

Romance

Nonfiction

Biography/Memoir

Tell us more about what you like to read or watch (preferred languages, favourite authors, favourite books, etc.)

How did you find out about the Visiting Library Service?

I agree

To be responsible for all items borrowed on this card.

To notify Visiting Library Service staff if I require additional time with an item.

To promptly report loss or theft of my library card.

To notify the Library if my contact information changes.

That if the Library cannot contact me for six (6) months that my space in VLS will be given to another patron.

That my borrowing history will be available to Library staff to better serve my needs.

Personal information on this form is collected under the authority of the Public Libraries Act and the Municipal Freedom of Information and Protection of Privacy Act. It will be used to lend library materials and to provide other library services in compliance with federal, provincial and municipal legislation and Whitby Public Library Rules of Conduct, Public Internet Policy, Privacy Policy and any other applicable library policies. Questions about the collection of personal information should be directed to the Manager, Community and Service Development, Whitby Public Library, or Library CEO.

Registration information is confidential. Information regarding your library use will not be given to any other person or organization, including family members. The only exceptions are that parents or guardians of children under the age of 16 may be given information about overdue or lost library material, and when disclosure is required by law.