APPLICATION FORM. 1: Personal details. 2: Statement of eligibility. Title. Name. Address. Postcode male female / / Date of Birth.

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1 1: Personal details APPLICATION FORM Title Name Address Postcode male female Tel. address 2: Statement of eligibility Date of Birth / / Calibre Audio Library charges a one-off joining fee of 35 for adults and 20 for under 16 s (inc. VAT) and thereafter is a free service. Please tick one of the boxes below and sign the declaration. I confirm that I am prevented from reading print because I have: a sight problem dyslexia another disability I will not copy, transfer, distribute, lease, license or publicly perform in any way an audio book lent by Calibre for the sole use of its members. Signature (Adult for under 16 s) Date Format: Memory stick MP3 CD Download Streaming

2 3: Adult reading choices Please select some of the categories below for the types of books you enjoy, even if you plan to create your own book list. Please choose no more than 8 categories. If you agree to receive x-rated (strong language etc.) books, tick here: FICTION General fiction 20th Century classics Contemporary fiction Classic fiction Adventure stories Animal stories Detective and mystery Cosy crime Erotic fiction Family stories Fantasy stories NON-FICTION Ghost stories Historical fiction Horror tales Humorous fiction Love stories Science fiction Short stories / anthologies Spy stories Thrillers War stories Westerns Animals Economics, politics and current affairs Arts General Plays, theatre and dance Biography: General Poetry Art, music and literature Psychology and sociology Diaries and letters Radio and TV journalism Entertainment Religion and philosophy Historical Science: General Humour Biological Political Earth and physical Sport Environmental Crime and law Technology Disabilities Sport and games Health and well-being Transport History: General Travel: British Isles Ancient Europe British World European Unexplained phenomena World War: General Home and garden World War I Humour World War II

3 4: Printed catalogues This information is available online at but if you would like to order catalogues, select them below and add the total to section 6. KEY STAGES (for under 16 s) Key Stage Key Stage Key Stage Key Stage FICTION General fiction Ghost stories th Century classics... 6 Historical fiction... 8 Contemporary fiction... 8 Horror tales... 2 Classic fiction... 6 Humorous fiction... 6 Adventure stories... 6 Love stories... 6 Animal stories... 2 Science fiction... 4 Detective and mystery Short stories / anthologies... 6 Cosy crime... 6 Spy stories... 4 Erotic fiction... 2 Thrillers... 8 Family stories... 8 War stories... 6 Fantasy stories... 6 Westerns... 2 NON-FICTION Animals... 4 Health and well-being... 2 Arts General... 2 Home and garden... 2 Biography: General... 8 Humour... 4 Art, music and literature... 6 Economics, politics & current affairs 2 Diaries and letters... 2 Plays, theatre and dance... 2 Entertainment... 6 Poetry... 6 Historical... 6 Psychology and sociology... 2 Humour... 2 Radio and TV journalism... 2 Political... 4 Religion and philosophy... 4 Sport... 4 Science: Complete Set... 4 Crime and law... 2 Sport and games... 2 Disabilities... 2 Transport... 2 History: General... 6 Travel: Complete Set... 6 Ancient... 2 Unexplained phenomena... 2 British... 4 War: Complete Set... 6 European... 2 World... 2

4 5: USB memory stick players Sovereign (manufactured by Kings Access Technology) Play, pause, skip forwards & back functions Large, highly visible controls with tactile markers Built in 3" speakers for full sound Pinpoint bookmarks multiple sticks Rewind & fast forward within a track 40 Price includes 2nd Class Royal Mail postage H 4" W 9" D 4" Weight: 1lb 11oz (787g) Sonic (manufactured by Kings Access Technology) Play, pause, skip forwards & back functions Pinpoint bookmarks multiple sticks Tactile, high contrast controls Ultra portable player Super sound quality, equal to the Sovereign 40 Price includes 2nd Class Royal Mail postage H 2 1/2" W 6" D 2" Weight: 8oz (235g)

5 6: Payment and order form Description Cost Adult Joining Fee (one-off cost) Under 16 s Joining Fee (one-off cost) Sovereign player (inc. P&P) Sonic player (inc. P&P) Three month free trial of our postal service FREE Total cost of any adult catalogues (see Section 4) Key Stage Catalogues 4 each KS1 KS2 KS3 KS4 Voluntary donation TOTAL COST Payment Cheque made payable to Calibre or Visa Debit Visa Mastercard Maestro Other Card number Valid from Expires end Issue no. CV2 no. Signature Date If you have filled this form in on behalf of someone else, please provide your details below Title Name Address Postcode Tel.

6 7: Keeping in Touch In order to provide our audio book service we need to maintain contact with you to issue books, provide information about new titles and any changes to our library service. Membership of our library includes consent to contact you with service and fundraising information through the communication methods which you have provided details for. Our service relies on voluntary donations in order to continue and we may send occasional fundraising communications by post which you may opt below not to receive: Please do not contact me by post, specifically about fundraising 8: Questionnaire The information that you provide here is very useful to Calibre for future planning and applying for grants. Please tick all the boxes that apply to you. 1. If you, or someone you were married to, has served in the armed forces (including National Service), please tick the relevant service: Army RAF Royal Navy Merchant Navy 2. Where did you receive this membership form? Thank you for providing this information. Please return your completed form to: Calibre Audio Library Aylesbury HP22 5XQ website: telephone: November 2017

* We will calculate a pro rata fee to upgrade your existing membership. Please contact our office for an individual quote.

* We will calculate a pro rata fee to upgrade your existing membership. Please contact our office for an individual quote. MEMBERSHIP TYPE New MAX $310 Upgrade from ACCESS Upgrade from PLUS We will calculate a pro rata fee to upgrade your existing membership. Please contact our office for an individual quote. Please check

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