Arizona State Library, Archives and Public Records Braille and Talking Books Division
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ARIZONA STATE BRAILLE
AND TALKING BOOK LIBRARY

ANNUAL APPLICATION for INSTITUTIONAL SERVICE
(Applications effective January - December)

Agency Name
 Contact Person
Address
 City
State

 ZIP+4
-
Telephone Number  
( ) - 		Extension
Message Number
( ) - 		Email
Type of Agency

 If Other, please describe:
Types of Service Requested
Books on Tape - Includes one 4-track tape player
Magazines on Tape - List of options will be mailed to you

Reader Profile - Check what applies to those who will be using the service
Books should be in:
If other, please describe:
Restrictions: (Please Select)
No explicit descriptions of violence
No explicit descriptions of sex
No strong language 		Reading Level: (Please select)
Juvenile
Young Adult
Adult
If Juvenile, please check all that apply:
 P-3   2-6   4-7   5-9
Please send us books from the following subject areas:
Subjects:
Adventure - Fiction ADV
Adventure - Non-Fiction ADVM
Animals - Fiction ANM
Animals - Non-fiction ZOO
Arizona - Fiction AZIH, AZIM, AZIW
Arizona - Non-Fiction AZNF, AZNFH, AZNFT
Arts and Crafts AC
Autobiography ABI
Best Sellers - Fiction BEF
Best Sellers - Non-Fiction BEN
Biography BIO
Books in Spanish SPL
Classics CLA
Family Stories FSTD
Fantasy Fiction FAN, SCFAN
Gentle/Nostalgic Fiction GENT
Historical Fiction HIF
Historical Fiction, U.S. Only HIFUS		 History HST
History - U.S. Only HUS
Horror Stories HOR
Humor HUM, MYSH, TRAH
Mysteries MYS, MYSA, MYSB
Nature - Non-fiction NAT
The Occult OCC, OCCN
Poetry POE
Psychology, Popular PSY
Religion REL
Romance ROM
Science Fiction SCF, SCFAN
Short Stories SST
Social Issues SOPP
Sports SPO
Travel TRA
Travel U. S. Only TRAUS
Westerns WES

Library may select books for this account from the subject areas marked above.
Send only books that we order (at least 4 books per year to retain equipment.)

 

Authorization Signature
I certify that this agency regularly provides service to individuals who are unable to read a regular print book because of a permanent or temporary visual or physical disability. I hereby request an institutional account with the Arizona State Braille and Talking Book Library in order to provide these individuals with the opportunity to enjoy recorded materials.
   

ADMINISTRATOR'S Signature

___________________________________

Date

___________________________________


Printed Name

___________________________________


Title

___________________________________

Phone

___________________________________
   

Mail the completed application and certification form to:

Arizona State Braille And Talking Book Library
1030 N. 32nd Street
Phoenix, Arizona 85008
Attn: Christine Tuttle
 

 

 

 

 

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Updated:  03/26/2007

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