Library Beyond Walls Application
Library Beyond Walls (LBW) is a complimentary mail delivery service provided by the Marin County Free Library (MCFL). This specialized program ensures that library materials are delivered directly to your mailbox at no cost. LBW is designed to serve those who are unable to visit the library due to temporary or long-term illness, limited mobility, or other qualifying circumstances.
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Date of Birth
*
-
Month
-
Day
Year
I would prefer communication by:
*
Phone
Email
No Preference
Do you have a Marin County Free Library Card
*
Yes
No
If yes above, What is your Library Card Number?
Material Selection (Please select one)
*
I prefer LBW to select materials for me
I prefer to select my own materials
The next three questions below should be filled out if you plan to have an alternate contact.
Alternate Contact: Name
First Name
Last Name
Alternate Contact: Email
example@example.com
Alternate Contact: Phone Number
Please enter a valid phone number.
PLEASE READ THE FOLLOWING BELOW AND ANSWER ACCORDINGLY
By selecting yes, I understand that this service is intended for patrons who are unable to visit the library due to temporary or long-term illness, limited mobility, or any other qualifying circumstance(s) and have no other reliable means of accessing a Marin County Free Library Facility. I self-certify that I qualify for this service and I understand that I must reapply every 2 years.
*
Yes
By selecting yes, I understand that all library items will be sent through the United States Postal Service. I also understand that sending and receiving library materials is a free service to me and I am responsible for returning materials through the USPS or directly to a MCFL branch.
*
Yes
By my signature below, I certify that all information disclosed is true and correct. I hereby agree to hold harmless and release the County of Marin, its officers, employees, representatives, and volunteers from any loss, liability, claim, suit or judgement that may arise out of, or in conjunction with, the Library Beyond Walls program.
*
Submit
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