Application


Name (First and Last):


Birthdate (MM-DD-YY):


Mailing Address:


Zip Code:


Telephone: Home Work

E-mail Address:


Residence Address:


Occupation:


Distance to Post Office:


Do you want books:

REQUEST ONLY? Check yes here is you want to receive library materials ONLY when you ask for a specific title, author, or subject. If you want REQUEST ONLY service, stop here and send us a list of requests. If you send a long list, we will send book shipments regularly until all requests are filled.


BY PROFILE?
Check yes here if you want to receive library materials automatically every 6-7 weeks. We will send your requests in addition to the titles we chose based on your profile. (Complete your profile below.)


We can send up to 20 books and 4 audiobooks (books on CD), movies (DVDs) and music (CDs) for a total of not more than 25 items. How many of each of these items would you like in each shipment? Please enter a quantity and then select the types of movies or music you prefer.


BooksVideosAudio Books

DVD Catagories
Alaskana
Children's
Feature Films
Health
How To
Science and Nature
Music CD's Categories
Alaskana Reggae
Blues Rap
Children's R and B
Classical Rock
Country Soundtracks
Folk
Gospel
International
Jazz

Adults in household (Names):

What percent of fiction (novels) or non-fiction (factual books) would you like?

%Fiction %Non Fiction


Favorite Authors:

Enter specific selections (or other interests) here:


Place the individual adult's number next to the type of books he/she would like to receive.


Fiction
Adventure Alaskana
Best Sellers Christian
Classics Contemporary Literature
Fantasy Historical Fiction
Horror Humor
Mysteries Romances
Science Fiction Short Stories
Westerns

Non-Fiction
Alaskana Religious/Inspirational
Adventure Science
Biography Nature
Best Sellers Art Technique
Health Art (specify below)
Crafts History (specify below)
Poetry Sports (specify below)
Psychology Self-Help
How-to Travel

Children in household (Names and year of birth):

  1.   Year of Birth 
  2.   Year of Birth 
  3.   Year of Birth 
  4.   Year of Birth 

What percent of fiction (novels) or non-fiction (factual books) would you like?


%Fiction %Non Fiction

Favorite Authors:


Enter specific selections (or other interests) here:


Place the individual child's number next to the type of books he/she would like to receive.

Fiction
Alaskana
Animals
Classics
Fantasy/Fairy Tales
Historical
Humor
Mysteries
Romances
Science Fiction
Non-Fiction
Alaskana
Biography
History
Hobbies(Specify)
Nature
Poetry
Science
Sports


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