Personal Information

Full Name:

Address:

City:

Postal Code:

Home Phone:

Cell Phone:

Email:

Alternate Contact Information

Alternate Contact Name:

Alternate Contact Phone:

Relationship to Contact:

Your Service Request

Do you have an Oshawa Public Libraries card?: Yes No

If yes, card number:

Reason for request:

Duration of service:

Permanent Temporary

If temporary, duration:

How would you like to pick up or receive your items?

I or a designate will pick up my items at the library
I would prefer for my items to be delivered to my home

Number of items requested per month:

If this request is for a child, what is their reading level:

Your Content Interests

Please check all formats which interest you:

Regular PrintMagazineLarge PrintPaperbackAudio BookDVDDAISY

Please check all topics which interest you:

AdventureAnimalsBiographiesBusiness/EconomicsCanadian FictionChildren’s MaterialChristianFamily SagasFantasyHistorical FictionHistorical RomanceHistoryInspirationalMedical ThrillersMysteriesReligionRomanceScienceSportsSuspense/ThrillerTravelTrue CrimeWarWesternsChild

Tell us more about your interests:

Who are your favourite authors?

What are your dislikes?

Terms of Service

I agree to be responsible for any loss or damage of library materials delivered to me as a result of this application and agree to abide by all rules and regulations of the Oshawa Public Library Board.

Oshawa Public Libraries will 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 will only be shared with CELA for the purpose of receiving their services in accordance with our Privacy Policy.