Homebound Request Form

The Ohio County Public Library offers a Homebound Service.  This free service will deliver books to your home at your convenience.  Please fill out the following information.

  1. Please provide the following contact information:

    First Name
    Last Name
    Middle Initial
    Home Phone
    E-mail
    Mailing Address

  2. Please identify and describe yourself:

    Age
    Sex Male Female

  3. Select any of the following options that apply:

    Morning Visit
    Afternoon Visit
    Early Evening Visit

  4. Please give simple directions to your home so that we may find our way to you safely:



Copyright © 2003 Ohio County Public Library]. All rights reserved.
Revised: 05/11/10