Home Delivery Service Application

Thank you for your interest in the home delivery service for eligible residents living in the Fayetteville Free Library’s service area. Please complete the entire form. A library staff member will get in touch via phone within five business days of the submitted application. If you have any questions about how to complete the form or the Home Delivery Service, please contact Jake Wicks, Circulation Supervisor, at jwicks@fflib.org or call 315-637-6374 ext. 328

Applicant's Name *

First

Last

Applicant's Phone Number *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Secondary Contact Name

First

Last

Secondary Contact Phone Number

Do you currently have a library card from one of the libraries in the OCPL System? *

Yes
No

What is your library card number?

Eligibility Requirements

Recipients of the home delivery service must be residents in the Fayetteville Free Library service area. In addition, recipients must meet one or more of the following requirements:

Check all that apply *

Short term illness or disability (recovery period lasting at least six weeks)
Long-term illness, weakened immune system, or disability (lasting longer than 6 weeks)
Senior citizen (over 65 years of age)
New parents (for the first six months after childbirth)

Comments/Notes