School Name
|
Contact Person
|
Address
|
City
|
State
|
ZIP+4
-
|
Message Number
(
)
-
|
Extension
|
School Level
Elementary School
Middle School
High School
|
Email
|
Types
of Service Requested
Books on Digital Cartridge -- Includes one Standard Digital Player
Magazines on Digital Cartridge - Magazines List will be mailed to you
BARD (Braille and Audio Recording Download)
Braille Web-Braille
|
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 languange
|
Reading Level: (Please select)
Juvenile (Check all that apply)
P-3 2-6 4-7 5-9
Young Adult
Adult
|
| Please send us books from the
following subject areas: |
Subjects: |
Adventure - Fiction ADV
Adventure - Non-Fiction ADVN, DISNF
Animals - Fiction ANM
Animals - Non-fiction ZOO
Arizona - Fiction AZIH, AZIM, AZIW
Arizona - Non-Fiction AZNF, AZNFH, AZNFT
Autobiography ABI
Best Sellers - Fiction BEF
Best Sellers - Non-Fiction BEN
Biography BIO
Books in Spanish SPL
Classics CLA
Current Events CUR
Family Stories FAM
Fantasy Fiction FAN
Folktales, Myths, Fairytales FOL
Historical Fiction HIF
History Fiction (U.S.) HIFUS, PIO |
History HST
History (U.S.) HUS
Horror Stories HOR
Humor HUMF, HUMNF
Music MUS, ABIM, BIM
Mysteries MYS, MYSA, MYSB
Nature - Non-fiction NAT
Newbery/Caldecott Awards AWNC
Paranormal Fiction PARA
Poetry POE
Religion REL, BIB, CHNF, LDS
Romance Stories ROM
Science Fiction SCF
Short Stories SST
Sports SPO, ABIS, BIS, SPB, SPF, SPK
Travel TRA, TRAH
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
(Principal, Superintendent, etc.)
___________________________________
|
Date
___________________________________
|
Printed Name
___________________________________
|
Title
___________________________________
|
Phone
___________________________________
|
| |
|
Mail the completed application
and certification form to:
Arizona Talking
Book Library
1030 N. 32nd Street
Phoenix, Arizona 85008
|
|
| |