HOMEBOUND DELIVERY SERVICE APPLICATION

Moline Public Library cardholders who love to read and have difficulty visiting the Library due to a temporary or permanent disability can take advantage of our Homebound Delivery Service. Books are selected based on your reading interests and requests are delivered to your home on a monthly basis, typically on the second Tuesday of the month. For further information, call (309) 736-5960.
E-mail Address:*
Name:*
Address:*
Telephone Number:*
14 Digit Moline Library Card Number:*
Emergency Contact:
Emergency Contact Phone Number:
How Many Items would you like delivered each month

 

Reason for requesting this service:

 

Please check the format of materials you would like to receive
 
Regular Print
Large Print
Paperback
Hardcover
Books on Cassette
Books on CD
Biography
Educational VHS
Educational DVD
Fiction
Magazines
Music CDs
Mystery
Non-Fiction
Romance
Science Fiction
Westerns
* Required