Application for Library Service

Date of Birth

Prefix/Pronoun

Residence or Facility (if applicable)

Phone Number

Alternate Contact

Relationship

Alternate Contact Email

Alternate Contact Phone Number

Eligibility & Certification

Please indicate the disability preventing you from reading standard print.

If you have a hearing impairment, please indicate the degree of hearing loss.

Moderate

Profound

Records pertaining to customers of this library are confidential, as provided for in the Personal Information Privacy Act of the Code of Virginia.

Military

Check here if you have been honorably discharged from the United States military.

Persons who are blind or have a print disability who have been honorably discharged from the United States military receive preference in the lending of books, recordings, playback equipment, musical scores, instructional texts, and specialized materials (Public Law 89-522).

Service Requested

I only want to download digital talking books and/or eBraille materials on my personal mobile device to read instantly with the free BARD Mobile application. Please provide your email address for BARD registration.

I have a personal mobile device and would like to access the free BARD Mobile application, as well as have materials sent to my home.

I only want the library to send books to my home.

BARD Materials

Digital talking books and magazines on cartridge/flash drive Braille on cartridge/flash drive.

Large Print Descriptive DVDs.

Hard copy braille books and magazines.

Music appreciation/braille or large-print scores/instructional talking books and magazines on cartridge/flash drive

Send Books to My Home

Digital talking books and magazines on cartridge/flash drive Braille on cartridge/flash drive.

Large Print Descriptive DVDs.

Hard copy braille books and magazines.

Music appreciation/braille or large-print scores/instructional talking books and magazines on cartridge/flash drive

Please provide any additional information you think may be helpful. (Authors, Subjects, Series, etc.)

I am interested in receiving books in languages other than English

Yes

Please Describe

Readling Level

Youth

Young Adult

Adult

Specify Grade Level

Language Exclusions

Some Strong Language

Strong Language

Sex Exclusions

Some Descriptions

Descriptions

Explicit descriptions

Violence Exclusions

Some Descriptions

Descriptions

Explicit Descriptions

Long Books (over 15 hours)?

Yes

How would you like to receive the National Library Service Talking Book bimonthly catalog?

Braille

Digital

How would you like to receive our quarterly newsletter?

Large Print

Please contact us for more information, catalogs, or to place requests.

(757) 385-2684
AccessibleLibrary@vbgov.com

You may also visit our website VirginiaBeach.gov/AccessibleLibrary.

Please visit the National Library Service Website at www.loc.gov/nls for the history of the NLS and answers to frequently asked questions.