Ohio County Public Library

OHIOCOUNTYPUBLIC LIBRARY

52-16TH St.Wheeling, WV26003

304-232-0244

Outreach Services Application

Outreach Services Specialist: Julia Bachmann

The Ohio County Public Library Outreach Program exists to provide delivery of library materials to patrons throughout OhioCounty who are either temporarily or permanently unable to access the library due to illness, disability or other limitation.

Please note: Library materials borrowed through Outreach Services are lent for a 30 day period and no fines are assessed for late returns. Unless a particular item is reserved by another patron, it can be renewed for another 30 day period. Outreach patrons will be responsible for any lost or damaged items.

Name: ______

Address: ______

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Library Card #: ______

Telephone #: ______

Reason for requiring outreach services: ______

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Readers Advisory Survey – Please complete front and back

Are you interested in books? Yes _____ No _____

FORMAT: Regular Print _____ Large Print _____ Paperback _____

Are you interested in audiobooks? Yes _____ No _____

FORMAT: Cassette _____ Compact Disc (CD) ______MP3 _____

Are you interested in DVD movies? Yes _____ No _____

Are you interested in Magazines? Yes _____ No _____

Please list magazines titles (ex. National Geographic) or subjects (ex. fashion) of interest:

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Are you interested in musical compact discs? Yes ______No _____

Please list artists or genres of interest: ______

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DELIVERY PREFERENCES

Would you like materials delivered: upon request _____ once a month _____ twice a month _____

How many items would you like delivered each visit? ______(up to 25 books, or 10 magazines, CD’s or DVD’s. Maximum number of items permitted at a time is 25)

PLEASE CHECK ALL TOPICS OF INTEREST

Include as much information as you can about your preferences. The more information you provide, the better we can serve you with materials you will enjoy!

FICTION

Historical _____ Inspirational _____ Mystery _____ Romance _____ Literature _____ Classics _____

Science Fiction _____ Western _____ Horror _____ Best Sellers _____ Award Winners _____

Please list specific FICTION authors, time periods, subjects or setting you enjoy from the genres you checked above:

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NONFICTION

Animals _____ Art _____ Biography/Memoirs _____ Crafts _____ Current Events _____

Health/Medicine _____ History _____ Humor _____ Psychology/Self Help _____ Religion _____

Inspirational ______Travel _____ True Crime _____ Cooking _____ Poetry _____

Please list specific NONFICTION authors, time periods, subjects, geographic areas, hobbies, historical figures, political, social, economic or cultural issues you enjoy from the genres you checked above. Remember, be specific, especially if you enjoy reading about politics. I don’t want to offend!:

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