Home Library Service Form

Home Library Service - Application Form

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This field is for validation purposes and should be left unchanged.

It may take 4-6 weeks from the time of application to first delivery. Please contact the Home Library Service at 905-546-3200 x1001 or hls@hpl.ca to inquire about the status of an application.
Name*
Address*
MM slash DD slash YYYY
Do you have a family member or friend available to pick up and deliver your items to you on a monthly basis?*

Declaration of Eligibility

Home Library Service is available for individuals living at assisted living facilities with staff capacity to distribute library materials to their residents. If you are staff at an assisted living facility and are interested in this service or are unsure if a resident has already signed up, please contact us for more information. For Individuals Living Independently, with capacity to collect and return library materials by mail, please contact us for more information.
Select Below*

Alternate Contact Person

Name*

Preferences

We keep a record of your reading preferences and the library materials you have borrowed in order to provide better service to you. This list and your personal information are kept confidential and are not shared. Do we have your permission to keep this information in our files and/or computer? If you choose "no," you could receive materials that have been previously delivered to you.
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Some library material may contain content that may offend. Please choose any that you WILL accept:

Material Types (Please check all that apply):

Print
Non-Print

What do you like to read? (Please check all that apply)

Fiction*
Non-Fiction*

Personal information contained on this form is collected under the authority of the Freedom of Information and Protection of Privacy Act, 1990. MFIPPA\Regulations 29. The information collected will be used in the process of the library’s business. Questions regarding the collection and use of personal information can be directed to: Chief Librarian, Hamilton Public Library, P.O. Box 2700, Hamilton, ON L8N 4E4.

This information will be submitted via email. .

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