Isle of Wight Council

Home Library Service

Not being able to get about easily doesn't mean that you cant have a library service. We can arrange for our specially equipped Home Library Service to call at your house. All we need is confirmation from your doctor (which we will obtain) that you are unable to visit your local library. Simply complete the details below and return the form to the address below. We will contact you after hearing from your doctor. Isle of Wight Library Service FREEPOST SCE15296 COWES PO1 8BR or to any Island library. We regret that currently we are unable to offer this service to people living in residential care or sheltered accommodation. Managers of establishments are welcome to arrange bulk collections for their residents from a convenient library. For further information or if you have any comments, please contact County Library HQ, 01983 203880 or email to [email protected]

Your Details

*	Forename
*	Surname

*	Building/house name/number
*	Street address
*	Town name
	County
*	Postcode
	Telephone number (include area code)
	Email address

Your Doctors Details

*

Doctors name

Address

	Building/house name/number
	Street address
	Town name
	County
	Postcode
	Telephone number (include area code)
	Email address
	Fax

If the application is being made on the applicants behalf, please complete:

	Enquirers name
	Telephone number
	Email
	Relationship to applicant
	Should we contact the applicant directly	Yes No
	Is the applicant aware of the application	Yes No

	Data Protection Act 1998
	This application may be monitored by the Isle of Wight Council for regulatory, quality control or crime detection purposes. Information from this application will be processed in accordance with the Data Protection Act 1998 for the purpose of processing your particular enquiry/request. The Isle of Wight Council ("the Council") is the data controller. By completing this form you consent to the Council contacting you by email or nominated contact method in relation to your enquiry/request. The information contained in this application may, in exceptional circumstances, be subject to disclosure to third parties under either the Data Protection Act 1998 or the Freedom of Information Act 2000 to the extent the law allows and in accordance with the Isle of Wight Council's Access to Information Policy . Disclosure will only be made where in all the circumstances it would be fair to do so and in the public interest. Please note that the Council may process your information in the absence of consent for the purpose of crime prevention or detection so far as is in accordance with the law. Sometimes we may use your information to keep you informed about services, goods or relevant issues that we believe may be of interest to you. If you wish to receive this information for these purposes please tick this box To improve the quality of other services that we provide to you the Council wishes to hold your non-sensitive personal information on a secure central database. This will enable all Council services to use this information when they are providing a service to/for you. If you wish your non-sensitive personal information to be held by the Council please tick this box

You may now obtain a printable version of your form by clicking the Print Form link at the bottom of the page

For all communications regarding this form please quote the following reference information

	Reference number:
	Date of submission:

Date printed: 07/03/2013