Home Delivery Online Application

If you are unable to visit the library in person, apply for our Home Delivery Service. If illness, injury, weather concerns, transportation difficulties, or any other obstacles prevent you from coming to the library, this service is for you.

The library will review your application and work with you to determine what kinds of materials you want. We can select materials for you based on your response to the questionnaire included in this application. Volunteers and library staff deliver materials on a monthly basis.

The Home Delivery Program provides extended loan periods and no overdue fines. Each participant must register for a library card if they do not already have one. This form must be completed with the participant’s information and signature. That person is the cardholder.

If you have questions about eligibility or other aspects of this service, you may contact Miriam Achenbach, Outreach Librarian and Home Delivery Coordinator at 508-624-6992 or marlboroughreference@cwmars.org.

Part 1 - Contact Information

The first part of the application will ask you for the contact information that the library needs in order to deliver items to you. If you have a library card, please include the number on the back of your card in the appropriate spot. If you do not have a library card, please leave that question blank and library staff will contact you about creating a library card.

Please note all required fields are marked with an asterisk.

Do you have a library card?*

By checking the box, I agree to assume responsibility for all materials checked out on this card number. I agree to notify the library of any changes in the information I have provided and to immediately inform the library in the event that my card is lost or stolen. I understand that my borrowing privileges can be suspended at any time if overdue materials, related fines and/or fees are owed.

Part 2 - Materials Preferences

Do you prefer large print?

Can you read regular print?

Would you like audio books on CD?

Would you like movies on DVD?

Would you like music CDs?

Please tell us your favorite authors, books, movies, and/or types of music:

Is there anything else you can tell us about your likes and dislikes, for example, if you dislike violence, gore, foul language, or sexual situations?

How many items would you like per month? (maximum 15)

May we leave your library materials with a caregiver, if need be?

Part 3 - Genre Preferences

Please indicate whether or not you are interested in each genre by checking the box next to the name.


Animal StoriesBiographiesBusinessHistorySportsTravelTrue CrimeArtCookingCraftsGardeningFolklore/MythologyHealthHumorInspirationalPoetryPoliticalSelf HelpReligionPhilosophyScience

Part 4 - User Agreement

I am unable to use the library because:

I understand that my library card is for my use only.

I will notify the library of any change in my address or phone number.

I will notify the library if my card is lost or stolen. I understand that I am financially responsible for all items borrowed on my card up to the point that I report the card lost or stolen.

I am responsible for all library materials that are checked out to me.While overdue fines are not charged, participants in the Home Delivery Program are responsible for lost or damaged items.

Patrons requesting home delivery services must provide a safe and appropriate environment for the people who make deliveries to their homes.

By applying for this service, I give permission to the Marlborough Public Library Staff to check out items for me on my library card and keep a record of my checkouts. This will prevent staff from sending repeat materials and assist them in choosing materials that fit my profile.

I agree to the terms and conditions listed above.
I verify that the information I have supplied on this form is correct.