Great Lakes Talking Books Service Application

Great Lakes Talking Books

A free braille and talking book library service for people with temporary or permanent low vision, blindness, a reading disability, or a physical disability that prevents reading or holding the printed page.
Service Area

All counties of the Upper Peninsula along with Alpena and Crawford County in the Lower Peninsula. Not in our service area? Find your library at https://www.michigan.gov/leo/bureaus-agencies/bureau-of-services-for-blind-persons/btbl/contact-the-btbl-network-libraries.
Eligibility

Individuals (all ages) are eligible for service provided they meet any of the following criteria: are blind or have a visual impairment that makes them unable to comfortably read print books, have a perceptual or reading disability, or have a physical disability that makes it hard to hold or manipulate a book or to focus or move the eyes as needed to read a print book.
Who can certify this application?

Doctors of medicine, doctors of osteopathy, ophthalmologists, optometrists, psychologists, registered nurses, and therapists. Professional staff of hospitals, institutions, and public/welfare agencies including educators, social workers, case workers, counselors, rehabilitation teachers, reading specialists, school psychologists, superintendents, librarians, and paraprofessional library staff.
Certify

To be completed by the certifying authority.
Date*

MonthDayYear
Date
Check here*

I certify that this applicant is eligible for NLS services.
Primary disability preventing the applicant from reading printed material.*

BlindnessVisual ImpairmentPhysical DisabilityReading DisabilityDeaf/Blindness
Email*
certifier email
Certifying Authority Signature*

Clear
Name*

Certifier First Last Name
Title*
Certifier Title
Organization*
Certifier Organization
Address*

Certifier Address

Street Address Line 2

Certifier CityCertifier State

Certifier Zip Code
Phone Number*
Certifier Phone Number
Veteran Status

Preference in lending of books and equipment is given to veterans.
Check here

for Veterans who have been honorably discharged from the U.S. Armed Forces.
Applicant Information

Note to Institutions: Is the purpose of this application to enroll an institution and not an individual? If so, please enter the institution name in the the last name field and enter the institutional contact (for example, activities directors, social services staff, or administrators) in the alternate contact section.
Name*

First Last
Phone Number
Address*

Street

Apt, Suite, Unit or Trailer

CityState

Zip Code
County*
example: Marquette, Ontonagon, Dickinson, or Alpena
Date of Birth*
Month/Day/Year
Email
example@example.com
Email Preference

Do not send me email messages.
Alternate Contact

Who should we contact if the applicant can't be reached? Note to Institutions: Is the purpose of this application to enroll an institution and not an individual? If so, please enter the contact information for the activities director, social services staff, or administrator in the alternate contact field.
Name

First NameLast Name
Phone Number
Email
example@example.com
Relationship to patron
Daughter, Caregiver, Friend, etc.
Service Options

Would the applicant prefer to download books and magazines using a device or receive a player and cartridges by mail? The applicant can do both, if they'd like.
Download

BARD. I have a personal mobile device (iPhone, Android, iPad, or Kindle Fire), an email address, and Internet access. I want to download digital talking books and/or eBraille materials to read instantly with the free BARD Mobile App.
By Mail

Digital Talking Book Machine. I want my talking book library to send a DTBM player and books on cartridge by USPS to my home.Headphones. I want my talking book library to send a headphones to use with my Digital Talking Book Machine.Hardcopy braille. I am a braille reader and want my library to send hardcopy braille books and magazines to me by USPS mail to my home.eReader. I am a braille reader and want my talking book library to send me a refreshable braille display.
Reading Preferences

Complete if patron wants library materials sent to their home through USPS Free Matter for the Blind.
Service Style: Check one.

Personal request only: Only send the titles I request.Auto-select: I wish to have books selected for me.
Note: you may still requets specific titles at any time, even if you prefer auto-select. Visit the NLS catalogue at this link https://nlscatalog.loc.gov/ to find titles.
If you chose auto-select, the library needs information about your reading interests. Please check all the types of books or subjects you prefer
Reading Level

AdultYoung AdultChildren's titles
Juvenile Grade
Example: Grades 4 and 5.
Subjects: Check all that apply.

AdventureBestsellers/FictionBestsellers/NonfictionBiographyClassicsCookingDisabilityGardeningHistorical FictionHistoryHorror/ParanormalMystery, Detectives, CrimePoliticsPsychology/Self-HelpRegional Interest (Michigan)Religious Fiction/AmishRomanceScience Fiction/FantasyTrue CrimeWar/MilitaryWesterns
Additional Subjects/Authors
Examples: John Grisham, Harry Potter series, sports books, etc.
Will you accept materials with the following content?
Language

YesNoSome
Violence

YesNoSome
Sex

YesNoSome
How did the applicant hear about us?
Check one

Veteran AffairsVocational Rehabilitation CenterOther Health Care ProfessionalFriend / FamilyPublic LibrarySchoolConsumer / Support GroupEvent / ExpoTV AdRadio AdOther Ad (please specify below)Internet / Social Media (please specify below)Other ( please specify below)
Specify the ad, internet, or other source:
I am interested to read books in languages other than English.
Example: German
For Minor Applicants Only

Parental Acknowledgment for NLS services and devices.
Check here

As the parent/guardian of the applicant, I acknowledge that my child will receive services and equipment and that my child will have access to the entire NLS catalog of reading material. All materials and equipment (including digital talking book cartridges, hard copy braille, players, and accessories) must be returned when no longer needed.
Parent/Guardian Name
Relationship to Applicant
Email Address
Signature

Clear
Questions?

1-800-562-8985, Ext. 0, 1-906-228-7697, Ext. 0, or mbrodeur@superiorlandlibrary.org
Should be Empty:

Great Lakes Talking Books

Service Area

Eligibility

Who can certify this application?

Certify

Veteran Status

Applicant Information

Alternate Contact

Service Options

Reading Preferences

How did the applicant hear about us?

For Minor Applicants Only

Questions?