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 Print
Magazine
Large Print
Paperback
Audio Book
DVD
DAISY
Please check all topics which interest you:
Adventure
Animals
Biographies
Business/Economics
Canadian Fiction
Children’s Material
Christian
Family Sagas
Fantasy
Historical Fiction
Historical Romance
History
Inspirational
Medical Thrillers
Mysteries
Religion
Romance
Science
Sports
Suspense/Thriller
Travel
True Crime
War
Westerns
Child
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
.