RNIB NATIONAL LIBRARY SERVICE Registration Form
Please return to:
PO Box 173
Peterborough PE2 6WS
This form can also be completed by telephone.
Tel: 0303 123 9999
Fax: 01733 375001
Minicom: 0845 758 5691
E-mail:
Website: www.rnib.org.uk/library
Opening hours: Monday to Friday 8.45am-5.30pm; (closed Thursday 2.30pm-4.30pm)
PART A - Reader's details
Title (Mr/Mrs/Miss/etc):
Surname:
First Name:
Date of Birth:
Address:
Postcode:
Telephone Number:
Email Address:
Second address
We can arrange to send your books to a different address if this helps you (e.g. school, college, work). Please give details if required:
Contact Name:
Address:
Postcode:
Telephone:
Email Address:
PART B - Library services required
Enter yes or no at the end of the line where appropriate.
Giant print books (free) :
Braille books (free):
Materials for adult braille learners (free):
Music resources (free) braille:
Music resources (free) Giant print:
Audio tutorial music CDs:
Talking Books on Daisy CD
(Annual subscription fee £50- less than £1 a week).
DAISY CDs can be played on many MP3 CD players or a specialist DAISY player. RNIB can offer advice about a player that may suit you.
Call Helpline 0303 123 9999
Do you require children's titles?
Would you be interested in downloading audio books from RNIB in the future?
Part C - How to make a payment for a Talking Book subscription
There is an annual subscription fee. This may be paid by your local authority or you can pay for yourself. A Talking Book subscription also makes an ideal gift - a present that can be enjoyed all year round - call us on 0303 123 9999 for details.
If you are paying for your own subscription - you will need to send payment with your completed application form. You can pay by direct debit, credit/debit card or by cheque.
Cheque/postal order should be made payable to RNIB and sent to: RNIB Talking Book Service, PO Box 173, Peterborough PE2 6WS.
Please ring us on 0303 123 9999 to pay by credit/debit card or set up a direct debit.
Do you wish to pay:
Quarterly:
Six monthly:
Annually:
10 monthly payments (Direct Debit only):
Enter yes or no at the end of the line where appropriate.
Who will be paying for your Talking Book subscription?
Enter yes or no at the end of the line where appropriate.
Yourself:
Local authority:
Local Society:
Other (e.g. relative, carer):
If someone else is paying for your subscription
(e.g. local authority, local society or relative/carer) - please provide their details below:
Name
Address
Postcode:
Telephone Number
Email address
PART D - Using the RNIB National Library Service
Number of books
We will replace your books as soon as you return them. We recommend that you return a book as soon as you have finished it. You can borrow up to six titles per format at any one time. Please state below how many books you wish to borrow:
Talking Books:
Giant print:
Braille:
RNIB has put a warning on Talking Books if they contain material unsuitable for family reading. Please state here if you do NOT wish to receive books which contain strong language, sexual or violent content.
Choosing your books
Enter yes or no at the end of the line where appropriate.
Send only the specific titles I request. Do not select books for me.
I wish to select my own books but please select books for me as well:
In order to provide your library service, we prefer you to give us a list of titles that you would like to read, but you may also wish to indicate your favourite categories from the list below so that we can ensure you are never without a book to read. Alternatively, our Reader Services Team (Tel: 01733 375333) can help you compile a list or send you book lists to choose from.
Fiction
Adventure
Chick lit
Classic fiction
Crime fiction
Erotic stories
Family stories
Fantasy
General fiction
Historical fiction
Horror
Romance
Science Fiction
Short stories
Sea stories
Thrillers/spy stories
War fiction
Westerns
Non-fiction
Biography:
History:
Country life:
Poetry:
Politics:
Science:
Sport:
Travel:
True crime:
War non-fiction:
Who are your favourite authors?
Please list any areas of interest
(e.g. gardening, cookery)
Read On and New Books
When you join RNIB National Library Service, you will receive our free 'Read On' magazine and 'New Books', a bi-monthly update of new titles available from RNIB for loan and/or sale. Please indicate your preferred format for:
Enter yes or no at the end of the line where appropriate.
Read On in Clear print
Read On on DAISY audio
Read On in braille
Read On by email
New Books in Clear print
New Books on DAISY audio
New Books in braille
New Books by email
PART E – Who can use our services ?
You are can join RNIB National Library Services if you are unable to comfortably read standard print with spectacles. You don’t need a GP or other professional’s verification.
Enter yes or no at the end of the line where appropriate.
If you are a teacher acting on behalf of a child or young person, do you have permission from their parent/guardian?
Terms and conditions
I understand that books under RNIB's loan scheme remain the property of RNIB and must not be copied, broadcast or publicly performed.
I declare that I am eligible for the service due to impaired reading vision (unable to comfortably read standard print with spectacles).
Signature:
PART F - About You
Enter yes or no at the end of the line where appropriate.
Please tell us if you are :
Blind:
Partially sighted:
Are you registered?
How would you like us to write to you?
Clear Print:
Braille:
Audio CD:
E-mail:
Please tell us where you heard about us.
Local Authority:
Local Society:
School/college:
Library:
Hospital:
Friend, relative or carer:
Exhibition:
Leaflet:
Newspaper/magazine:
Website:
Radio:
Talks:
Another part of RNIB:
Other (please specify):
Occasionally, RNIB may wish to contact you with information which may be of interest to you. May we send you information about:
Products:
Services:
Ways to support RNIB:
RNIB may from time to time pass your details on to reputable external organisations.
May we pass your details on?
Thank you for joining RNIB National Library Service.
Your application should take five to seven working days to process. If you haven't heard from us within 14 days of your application, please contact us on 0303 123 9999.
Registered Charity No 226227
VAT Registration No. 524 4558 45
NL10003P
November 2013