Utah State Library for the Blind and Disabled

Application Instructions

You may use the print function of your browser to print this letter and read it thoroughly.

Please print and fill out the Application For Free Library Service completely regarding the type of equipment required, service preferences, and reading interests. All equipment is on loan, free of charge, in accordance with policies and procedures of the National Library Service for the Blind and Physically Handicapped of the Library of Congress.

An original signature by a competent authority is essential in order to receive library service. In the case of a Reading Disability, the form must be signed by a Medical Doctor (M.D.) or Doctor of Osteopathy (D.O.). Visual and physical impairments may be certified by other professionals. The competent authority may not be a member of the applicant's family.

You must mail the certified application to the library or bring it into the library. An original signature (not a signature stamp) by the certifying authority is required for certification. Faxes or copies of the certification are not acceptable. Improperly certified applications will be returned to you.

RETURN THE COMPLETED APPLICATION FORM TO:
Utah State Library - Program for the Blind and Disabled
250 N 1950 W, Suite A
Salt Lake City, UT 84116-7901

NO POSTAGE IS REQUIRED.

Application Form

When your application is received, the equipment requested and appropriate catalogs and informational materials will be sent to you.

If you have any questions, please do not hesitate to call one of the phone numbers listed above, Monday - Thursday, 7:00 AM to 6:00 PM. You may leave a message after hours. You may also email the library at blind@utah.gov. The Library staff looks forward to serving you.

Sincerely,

Staff of the Utah State Library for the Blind and Disabled