Future Reflections Winter 1993, Vol. 12 No. 1
KENNETH JERNIGAN LIBRARY FOR BLIND CHILDREN
A Division of American Action Fund
for Blind Children and Adults
18440 Oxnard Street
Tarzana, California 91356
******APPLICATION FOR LIBRARY SERVICES******
Applicant's Name_(PRINT)_________________________________________
Mailing Address_(PRINT)__________________________________________
City, State, Zip_(PRINT)_________________________________________
If applicant is a minor, please name parent or guardian
_________________________________________________________________
The books offered by the KENNETH JERNIGAN LIBRARY are available in the following Grade levels:
CHECK The Grade Level Of The Books You Desire.
Pre-School
Kindergarten
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
Grade 7
Grade 8 (young adult)
Is subscriber...
BLIND ADULT?__________
BLIND CHILD?__________
Birthdate of Child________
PLEASE READ THE BACK OF THIS APPLICATION
Agreement Covering Library Services.
As conditions for the privilege of borrowing books from the Library, I agree to keep the Library informed of change of address, to care for all books properly, and to mail books back to the KENNETH JERNIGAN LIBRARY within a period of 90 days or arrange for an extension before due date. I have read the conditions on the reverse side of this application.
Signature: ____________________________________Date______________
CONDITIONS
Library books are distributed free of charge to subscribers. Books are sent to subscribers for a period not to exceed three months. Overdue books will suspend lending privileges. A request for extension of time is available upon request. Return books to the Library in the same mailing-box in which the books were sent. It is only necessary to pull out the mailing label and reverse it. The return address is printed on the reverse side.
NO POSTAGE IS REQUIRED.
Books are graded by reading level. When applying for service, please be sure to include the reading level of the books you require. Specific titles may be requested or reserved. Requested books will be sent as soon as the title becomes available. Please call attention to damaged books or books with missing pages.
KENNETH JERNIGAN LIBRARY FOR BLIND CHILDREN