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Home Delivery Application

  1. Enter the information for the primary Home Delivery Program user here:
  2. The best way to contact me is:*
  3. Emergency Contact
  4. Is your emergency contact authorized to receive information about your library account if needed?
  5. Acknowledgement of program eligibility: Individuals who live in the Town of Clayton and Town of Clayton ETJ, are library cardholders in good standing, and are unable to get to the library because of age, disability, illness, and/or the coronavirus public health crisis are eligible to participate in this program.
  6. Please check all that apply to you.
  7. If you selected other please provide more information.

  8. Home Delivery Program Information

    Patrons are asked to select their own materials using the library's online catalog or, if this is not possible, by calling a library staff member for assistance during library hours.

  9. Check the box that most closely explains your selection abilities:*
  10. Indicate your preferred format (check all that apply).
  11. If you selected other please provide more information.

  12. Leave This Blank:

  13. This field is not part of the form submission.