2. ZBWPL Barcode*
   Please use the barcode assigned to your membership at the Zula B Wylie Public Library
4. First Name*
5. Last Name*
7. Address1*
9. Address2*
11. City*
12. State
13. Zip*
15. Phone
17. Email address
19. Location Instructions for Delivery*
    Please let us know where at your address you would like the library to place your items, such as front door, garage door, behind plant, etc
21. Reason*
    -- Select One --ElderlyTemporary DisabilityHomebound with no one to driveIllnessOther

    Select one
23. If Other chosen above, please describe reason for needing home delivery.
    Only complete if you chose Other above.
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24. Submit

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