home > library information > outreach services > at home > at home application At Home Application First Name: Last Name: Middle Initial: Street: Apt: City: Zip: Birthdate: Is this address a senior residence, nursing home or assisted living? Yes No If yes, which one? Telephone: ex. 952-000-0000 Email: Are you unable to visit a library because of: Illness Visual Impairment Disability Other  How long do you need service: 2-6 months Winter only Ongoing How do you prefer to receive materials: By Mail (postage is paid both ways) By Volunteer If volunteer, do you know someone who is willing to bring you materials?  Name  Phone Do you have a library card? Yes No Library Card Number: What format of reading materials do you prefer? (check as many as apply) Large print Regular print Books on Compact Disc DVD To help us choose materials for you, please tell us some of your favorite authors, titles, or subjects: How did you hear about At-Home Service? Friend Relative Hennepin County Library staff Human services agency Other Please provide the following emergency contact information: Name: Relationship: Phone: Signature:   CONTACT US   At-Home 952-847-8850 Corrections 952-847-8852 Senior Housing 952-847-8858 VOLUNTEER   •  Deliver books to customer's homes, assist at senior assisted living facilities, or donate magazines for correctional facilities. •  Complete an Online Information Request form if you are interested in any of the above opportunities or call the Volunteer Coordinator, 952-847-8545. RESOURCES   Accessibility Eliminating barriers that make it difficult for people with disabilities to use library services. Life Stages & Caregiving Information resources of particular interest to seniors and those who care for older adults. © Hennepin County Library We welcome your comments and suggestions.