Great Lakes Talking Books Library Application

Great Lakes Talking Books Library

A Service of the Bureau of Services for Blind Persons, Labor & Economic Opportunity
1615 Presque Isle Ave Marquette, MI 49855-2811

Local Phone: 1-906-228-7697, Ext. 0 Email: tb@greatlakestalkingbooks.org Toll Free: 1-800-562-8985, Ext. 0 Web: greatlakestalkingbooks.org
Application for Free Library Service
Date

Month Day Year
Date
Name

First Name Last Name
Address

Street Address

Apt

City State

Postal / Zip Code
Phone Number

Area Code Phone Number
Birth Year
Gender
Email
example@example.com
Veterans

Veterans, please check here if you have been honorably discharged from the U.S. Armed Forces. By law, preference in lending of books and equipment is given to veterans.
Person to call if you can't be reached and/or to assist with your account:

First Name Last Name
Phone Number

Area Code Phone Number
Relationship to Patron
Check one of the eligibility requirements under which you qualify.

Blind: Visual acuity of 20/200 or less in the better eye with correcting glasses or the widest diameter of visual field subtending an angular distance no greater than 20 degrees. Visual Disability: Unable to read standard printed materials without special aids other than regular glasses. Physical Disability: Unable to hold a book or turn the pages as a result of weakened muscle or nerve control due to strokes, arthritis, multiple sclerosis, polio, or other physical conditions that impair the use of arms or hands. Reading Disability: Organic dysfunction, such as dyslexia, of sufficient severity to prevent reading. IF THIS BOX IS CHECKED, doctors ofmedicine (MD) or osteopathy (DO) who may consult with colleagues in associated disciplines must certify.
To be completed by certifying authority

(Certifying authority must be a professional such as a doctor, nurse, rehabilitation professional, counselor, librarian, teacher, activity director, or social worker) I certify that the applicant named on the previous page is unable to use standard printed materials for the reason indicated above, and that I am not a member of the applicant’s family.
Signature

Clear
Date

Month Day Year
Date
Name

First Name Last Name
Title and Occupation
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number

Area Code Phone Number
Email
example@example.com
Books, Equipment, and Other Services

Talking Books on digital cartridge and a digital talking book player. Easy-to-use digital player; plays book cartridges. BARD (Braille and Audio Reading Download). Download books with the BARD mobile App directly to compatible mobile devices, such as an iPad. Braille Books Headphones Magazines NFB-Newsline Service. Audio newspaper service High Volume Player. Solely for use by readers with profound hearing loss. Separate application needed.
What is your preferred reading level?

Adult Young Adult Juvenile
If Juvenile reading level, please specify grade and/or reading level:
How did you learn about this service?

Veteran Affairs Vocational Rehabilitation Center Other Health Care Professional Friend / Family Public Library School Consumer / Support Group Event / Expo TV Ad Radio Ad Internet / Social Media Other ( please specify below)
If you checked other above, please specify:
Book content preferences. If you don't mind books with strong language, violence, and sex, skip this section. Please note that Westerns and Mysteries usually contain violence.

No Strong Language No Violence No Explicit Sex Some Strong Language, Violence, and Sex is ok.
Every other month we send talking book patrons a catalog of newly recorded books, known as the Talking Book Topics. What format do you prefer to receive?

Large Print Audio
For Braille patrons only. Every other month we send patrons a catalog of newly added braille books, known as the Braille Book Review. What format do you prefer to receive?

Large Print Braille
In what format would you like to receive newsletters?

Large Print Braille Email Online ( Statewide: www.michigan.gove/btbl Local: greatlakestalkingbooks.org)
Select your favorite authors:

John Grisham Clive Cussler James Patterson Mary H. Clark David Baldacci Donald Bain William Johnstone Zane Grey Louis L'Amour Stephen King Dean Koontz Janette Oke Jan Karon Richard P. Evans Nicholas Sparks Maeve Binchy Nora Roberts Danielle Steel Beverly Lewis Debbie Macomber Barbara T. Bradford
Other authors:
Fiction Subjects:

Animals and Nature Adventure: Bestsellers Adventure: Sea Stories Adventure: Spy Stories Fables/Folklore/Mythology Family Historical Fiction: Foreign Historical Fiction: U.S. Horror Literature Modern Fiction Mystery: Bestseller Mystery: Detective Mystery: Historical Romance: Bestseller Romance: Old Fashioned Science Fiction: Bestsellers Science Fiction: Fantasy War Stories: Civil War War Stories: WWI War Stories: WWII War Stories: Korean War Stories: Vietnam Westerns
Nonfiction Subjects:

Adventure Biography: Celebrity Biography: Historical Biography: Music Biography: Political Business & Economics Cooking History: World History: United States Inspirational Philosophy Poetry Psychology Regional Interest: Great Lakes Regional Interest: Upper Peninsula Religion: Catholic Religion: Protestant Religion: Judaism Religion: Other Science Social Issues Sports: Baseball Sports: Hockey Sports: Basketball Sports: Soccer Sports: Football Sports: Golf Sports: Hunting Travel: World Travel: United States True Crime War: Civil War War: WWI War: WWII War: Korean War: Vietnam
Notes to Applicant

Once your application is received, the library will send a new patron packet. This will include a welcome letter, one or more of the library’s latest catalogs for ordering books, and additional information about the program. The library will also process your subscription to “Talking Book Topics” and/or “Braille Book Review,” which will be mailed directly to your residence going forward. This will let you know about the latest books at the library. All records pertaining to this service will remain confidential. To remain an active patron in our service, borrow at least one book or magazine per year. If you have any questions concerning this information, or need additional assistance in completing this application form, please call GLTB Toll Free at 1-800-562-8985 Ext 0, or local calls, 1-906-228-7697 Ext. 0. The Great Lakes Talking Book Library is open from 9:00 a.m. to 5:00 p.m. Monday, Tuesday, and Thursday. Please call ahead if you would like to visit.
Equipment Notice

The machines and special accessories are supplied to eligible persons on extended loan. If this equipment malfunctions, please call the library for instructions. If the equipment is no longer being used for reading recorded material provided by the Library of Congress and its cooperating libraries, please return it to GLTB.
Notice to Institutions

Institutions may use this application to request service. In this case, the applicant name on the first page of the application should be the name of the institution, with the contact person listed as the person filling the application out. Special rules and regulations may apply to those types of accounts. For example, schools are required to list the students that will be using the service along with their qualifying disability. Yearly recertification may be required. Please contact the library to discuss institutional accounts further.
Institution Notes (Schools - list eligible students and their qualifying disability here):
Should be Empty:

Great Lakes Talking Books Library

1615 Presque Isle Ave Marquette, MI 49855-2811

Application for Free Library Service

Notes to Applicant

Equipment Notice

Notice to Institutions