EmailMe Form - Adult Summer Reading 2016 at NCLBPH

I confirm that I am a registered patron of the NC Library for the Blind and Physically Handicapped *
Yes, I am a registered patron of the library
Name *
First Last
Please fill in your first and last name so that we can verify you are a patron of NCLBPH
Patron ID (if known)
Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Email (optional)
Phone Number *
### - ### - ####
I have read and agree to the promise to have fun this summer *
Yes, I agree.
You agree that by signing up for the Adult Summer Reading program at NCLBPH you will read as many books as you can, provide timely updates so that you can be entered into drawings for fun prizes.
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