St. Louis County Library brings the library to you! Services are provided to patrons of all ages who, for whatever reason, experience difficulty visiting a library branch. Our goal is to connect you with the rich resources the library has to offer. What type of service are you interested in? * Retirement/Assisted Living/Skilled Nursing Service School Bookmobile In-Home Daycare Facility Name Address City State Zip Code Email Address Owner's Name Activity Director's Name Fax Number Preferred Contact Person Name Preferred Contact Email Address Preferred Contact Phone Type of Facility Retirement Community Assisted Living Skilled Nursing Current Census Capacity Number of Readers? Cognitive levels? Number who need special service: Blind Deaf Other Do you have a secure Alzheimer's Ward? Yes No What time are residents ready for visits in the morning? What time is lunch? Please list dates of holidays or special activity days when we should not visit. Which days of the week bad for your facility? Monday Tuesday Wednesday Thursday Friday Are you interested in being contacted about other available services? Yes No If you would like to have your school considered by Bookmobile Service for the upcoming school year, please complete the application. Once all paperwork has been signed and received, schedule will be created for the upcoming year. Due to space limitations, we cannot guarantee a spot for all of the schools that apply; however, we will do our best to serve you. This application can be used to renew school bookmobile service and for new schools to apply for new schools to apply for bookmobile service. School Name School District School Address City State Zip Code Principal's Name Contact Person Librarian's Name Phone Number Contact Email Address Estimated Enrollment Number of Classrooms that will us the bookmobile? Is your school a polling place? Yes No First Day of School: month/day Last Day of School: month/day Dates school is not in session: School Day Hours: Winter Break Dates Spring Break Dates Early Dismissal Dates School Testing Dates What time do buses/cars leave and return in the morning and afternoon? Additional information Are you interested in receiving Summer School Bookmobile Service? Yes No I will contact 314-994-3300 ext. 2333 The St. Louis County Library will mail requested materials to your facility on a regular schedule. This is a free service extended to those who provide childcare services in their home. Name of Child Care Center Contact Name Phone Email Address Address City State Zip Code Number of children anticipated: 0-2 years - None -012345678910 3-5 years - None -012345678910 5 years and older - None -012345678910 How will you primarily request library material? I will place my own requests through the library's web site I will call Bookmobiles & Mobile Services with a list of items to place on hold I would like assistance from a librarian to choose material for me CAPTCHAThis question is for testing whether or not you are a human visitor and to prevent automated spam submissions. What code is in the image? * Enter the characters shown in the image.