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Library for the Blind and Print Disabled

Library@blind.state.ia.us

524 4th St Des Moines, IA 50309

515-281-1323

Application for Free Library Service

Iowa Library for the Blind and Print Disabled

The Iowa Library for the Blind and Print Disabled provides services to individuals with:

  • Blindness
  • A visual disability that prevents the reading of standard printed material.
  • A physical disability, such as multiple sclerosis, paraplegia, or paper allergies, that interferes with the ability to hold a book and turn pages.
  • A reading disability resulting from organic dysfunction.

Hospitals, nursing or convalescent homes, schools or other institutions serving visually or physically disabled persons may also register with the library.

Certification

Applications for LBPD service must be certified by a competent authority.

In the case of visual or physical disability, a competent authority is defined to include:

  • physician
  • osteopath
  • ophthalmologist
  • optometrist
  • registered nurse
  • therapist
  • professional staff of hospitals, institutions, and public or welfare agencies (e.g., social worker, case worker, counselor, rehabilitation teacher, or superintendent).
  • professional librarian

Applications for reading disabled persons must be certified by a physician or an osteopath. More information about the certification for individuals with reading disabilities may be found in Talking Books and Reading Disabilities, a factsheet produced by the National Library Service for the Blind and Print Disabled.

Full Name

Date of Birth

Full Address

Gender

Additional Information

Contact Person: Person to contact if you can’t be reached or can assist with your account:

Contact Person Name

Contact Person Information

Eligibility Requirements

Certifying Authority Information 

In the case of visual or physical disability, Please list below a competent authority is defined to include:

  • physician
  • osteopath
  • ophthalmologist
  • optometrist
  • registered nurse
  • therapist
  • professional staff of hospitals, institutions, and public or welfare agencies (e.g., social worker, case worker, counselor, rehabilitation teacher, or superintendent).
  • professional librarian

Certifying Authority Information

Facility

Facility Address

Library Services

All books and equipment can be sent and returned through the mail free of charge. Please select below the services you would like to receive. You may check multiple services.

 

Equipment Policy: Playback equipment and special attachments are supplied to eligible persons on extended loan. If this equipment is not being used in conjunction with reading material provided by the Library of Congress and its cooperating libraries, it must be returned to an issuing agency. Your cooperation in returning these items in a timely manner is appreciated.

Services

Optional Equipment

Other Services Offered

Programs for Kids

Choose one option for receiving books

Do we need to exclude books containing the following?

Preferred Language for Reading

Reading Level

Select the topics you would like to receive

Fiction

Non Fiction

I would prefer catalogs and newsletters in

Additional Topics

How did you learn about the NLS free library service (check up to 3 that apply?)

If you are a PreK-12th Grade Student fill out the following.

If this section doesn't apply to you click next to continue. 

School Address

Teacher/TVI Information