Home library direct service

This form will take approximately 10 minutes to complete.

Your data privacy

Before completing this form please read our general Privacy Policy (opens in a new window).

This explains why we ask for your data, what we do with it and how long we will keep it. It also explains how you can find out what data we hold about you and how you can ask us to delete it.

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Title *

Select your title.

Other

Enter your title if not listed above.

First name *

Enter your first name.

Last name *

Enter your last name.

House name/number *

Enter the address name or number. This could a flat, house or building name or number.

Address line 1 *

Enter the first line of the address. This could be the street name.

Address line 2

Enter the second line of the address if you need to. This could be the village name.

Town/city *

Enter the town or city of the postal address.

Postcode *

Enter the postcode, with or without spaces.

Email address

Enter an email address where we can write to you.

Phone number *

Enter a daytime phone number that we can ring you on. This can be a mobile or land line number.

Alternative phone number

Enter another phone number we can reach you on. This can be a mobile or land line number.

Local library

Select your nearest library.

Likes

Enter the types of books you like.

Dislikes

Enter the types of books you don't like.

Can you tell us why you need this service?

Enter why you need this service.

Would you like large print books? Select 'Yes' or 'No' as your answer. Yes
No

Would you like audiobooks? Select 'Yes' or 'No' as your answer. Yes
No

Please provide details of someone we may contact if we are unable to reach you.

Title (alternative contact) *

Select their title.

Other (alternative contact)

Enter their title if not listed above.

First name (alternative contact) *

Enter their first name.

Last name (alternative contact) *

Enter their last name.