Check this box if you wish to receive books in English language only. to receive books in other languages, list the languages:
If you wish
 Explicit descriptions of sex
Please print or type: Name
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To Be Completed by Certifying Authority (See section B, page 4, for definitions.)

Reading Preferences
Check A or B
A.	 Send only the specific titles I will request.

Do not select books for me.
B.	 I wish to have books selected for me. If you wish to have books selected for you,
	the library needs information about your reading interests. Please check the types
	of books or subjects you prefer, or write your reading interests in the space
	provided below:
 Adventure stories
 Animals, wildlife
 Bestsellers
 Bible, religion Denomination
 Biographies
 Business, economics
 Career, job training
 Children's fiction: reading level
 Children's nonfiction: reading level
 Classic novels
 Computers
 Cooking, homemaking 
Other categories are: 
  Drama
 Family stories
 Fantasy
 Folklore
 Gardening
 Gothic novels
 Government, politics
 Health
 Historical fiction
 History U.S.
 History world
 Humor
 Music appreciation
 Mysteries
 Nature
 Occult, supernatural 
 Philosophy
 Poetry
 Psychology, self-help 
 Romance
 Science
 Science fiction
 Short stories
 Sports
 Spy stories
 Stage, screen
 Suspense stories
 Travel
 War, war stories
 Westerns
I do not wish to receive books that contain: 
 Strong language             Violence
Title and occupation
I certify that the applicant named has requested library service and is unable to read or use standard printed material for the reason indicated on page one of this form.
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