I have a print disability as defined by Canadian copyright law and am eligible for CELA service
Yes, I have a print disability
No, I do not have a print disability
Types of disability
(Optional but this helps CELA better understand whom they serve)
Learning
Physical
Visual
Name:
Gender:
Male
Female
Non-Binary
Prefer not to specify
Date of Birth (required for people under 18):
Address:
City:
Postal Code:
Phone:
Email:
Preferred language of communication
English
French
Library Card Number:
Name of Guardian if 16 or Younger:
Are you already a CELA (CNIB) member?
Yes, I am a CELA member
No, I am not a CELA member
I wish to use a designate
(a designate will have full access to your account)
Yes, I wish to use a designate
No, I do not wish to use a designate
Designate Name:
Designate Relationship to Customer:
Designate Phone:
Designate Email:
As designate, I understand that the library materials I request or download are for the exclusive use of the patron with a print disability who is to receive service and not for my own use. I agree to respect the patron’s privacy and freedom to read a wide variety of materials and viewpoints. If the patron is not present during the completion of this form, I agree to inform the patron of the terms and conditions of my role. CELA may contact the patron to confirm that consent has been provided. I understand that violation of these terms will result in the cancellation of service.
I agree
Are you interested in the use of the Oshawa Public Libraries’ in-house DAISY collection or Victor Reader?
Yes, I am interested in the DAISY/Victor Reader
No, I am not interested in the DAISY/Victor Reader
Delivery Method(s) for CELA Program:
Download books to my computer or mobile device (tablet, smart phone)
Download books to a Victor player over a wireless connection (without a computer)
Receive CDs, braille or described movies by mail, direct to my home
Download from digital library and receive items by mail, direct to my home