Home Delivery Form

Please use this form to register for Home Delivery Service. Contact Sandra Toland at 920-236-5206 with questions regarding this service.

Emergency Contact
Emergency Contact Address

May we keep a reading list for you?

Keeping a reading list will help avoid duplication of titles selected and delivered to you.

Do you prefer books to be:

(Check all that apply)

Example: Music on CD (please include type of music), magazines (specific titles), movies on DVD (please include type or specific titles)
How many library materials would you like delivered each month?

What genres of Fiction do you like to read? 

(Please check all that apply)

Do you like to read Nonfiction?

(Please check all that apply)

My favorite types of books and/or authors are:

(please include any additional types of books you like to read including favorite authors or titles)