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Home Library Service - Application Form

Mandatory fields are indicated by a red asterisk
 
I wish to apply for the Home Library Service and agree to my details being forwarded to a registered WRVS volunteer.
Please note we will not be able to proceed with this request with out the authorisation box being ticked.
 
Title *
 
What format would you like your reading materials



Reading Preferences










 
Days to avoid visiting






Times to avoid visiting



 

Please complete the following;
Sight/Sighted *

Hearing *

If you have any queries, please contact Mrs Celia Steer on telephone 01472 323651, or e-mail museumsandlibraries@nelincs.gov.uk
Please click on the "Submit" button once to send us your form

DATA PROTECTION NOTICE
North East Lincolnshire Council is a Data Controller for the purposes of the Data Protection Act 1998. Any personal information supplied on this form will be processed in accordance with the principles of the Act. If you want to find out more about your rights under the Act, you can contact the Office of the Information Commissioner (tel: 01625 545 700 / http://www.dataprotection.gov.uk) or the Director of Law and Democratic Services on 01472 313131.



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Created by   :   Archivist
Last Updated   :   06 May 2008

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