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* Forms also available in Chinese, Vietnamese, Spanish or Braille. All versions except Braille are on the library's website at oaklandlibrary.org, under Disability Services.

Oakland Public Library offers Extended Services to persons with disabilities. Under the guidelines of the ADA, or Americans with Disabilities Act, disability means, with respect to an individual, a physical or mental impairment that substantially limits one or more life activities of that individual.

If you are a person with a disability, fill out an application for Extended Services for Library Patrons with Disabilities. Mail, fax, or return the application form to the Oakland Public Library- Main Library, Attention: Extended Services Coordinator, 125 14th Street, Oakland, CA. 94612.

Fax: (510) 238-2125 Or turn it in to any branch library, and they will send it to the ES Coordinator.

You will be registered for extended services within five days after your application has been received by the Extended Services Coordinator. The application process is kept confidential and the type of disability will NOT be placed in the library database. A code “ES” for Extended Services will be added to your record.

If you have questions about extended services or other services for persons with disabilities, call Lynne Cutler, Services for Persons with Disabilities and for Older Adults

Access Services, at 238-4974 (V) or 834-7446 (TTY).

Extended Services for Patrons with Disabilities include the following:

• Ability to apply for an Oakland Public Library card and for Extended Services by mail.

• Ability to authorize one or two individuals to check out your library materials for you.

• Automatic extension of circulation periods on all items which usually circulate for 3 weeks. ES patrons get six weeks on these items. Renewals are only for three weeks.

• Descriptive videos go out for six weeks to ES patrons and can be reserved and sent to any branch, and returned to any branch.

• 50 holds at a time, instead of 15.

• Answers to ready reference questions photocopied from a reference source and either faxed or mailed directly to your home. (Limit: one question and five photocopied pages per day.) If you call for this service, please tell the librarian that you are an ES patron. There is no charge.

SEE ALSO: "Guide to Services & Materials for Persons with Disabilities" which lists other services and adaptive technologies available at the library.

OCTOBER, 2007

Oakland Public Library
APPLICATION for Extended Services
for Patrons with Disabilities

Name_____________________________________________

Address __________________________________________

City, Zip code ______________________________________

Phone number _____________

1. DO YOU HAVE A CURRENT OAKLAND PUBLIC LIBRARY CARD? Yes__ No__
If NO, please fill out the application for a library card and return it with this completed form. If you are at any location of the Oakland Public Library, the staff there can give you a library card right away. They will mail or fax the application for Extended Services to the Coordinator of that program, and you will be registered for extended services within five days.

The following two questions are optional, but they allow us to know what services might be needed, and what barriers exist. They also help us with efforts to gain more funding for disability services. Thank you!

2. WHAT IS YOUR DISABILITY?

__________________________________________

__________________________________________

__________________________________________

3.HOW DOES YOUR DISABILITY AFFECT YOUR ABILITY TO USE THE LIBRARY?

__________________________________________

__________________________________________

__________________________________________

4. WOULD YOU LIKE TO AUTHORIZE SOMEONE ELSE TO CHECK OUT YOUR LIBRARY MATERIALS FOR YOU? Yes__ No__
If Yes, write their names below (two people maximum, you can change these later). The persons you authorize must have their personal identification and your library card with them when they check out your materials.

________________________________________________

PLEASE MAIL OR RETURN THIS COMPLETED FORM TO:

OAKLAND PUBLIC LIBRARY - MAIN LIBRARY
EXTENDED SERVICES COORDINATOR
125 14th STREET
OAKLAND , CA. 94612  

OR FAX IT TO: (510) 238-6934

You will be registered and may use extended services within five days after this application is received by the Extended Services Coordinator. If you also applied by mail for your library card, the card will be sent to you. Extended services are good at the Main Library and at all branches of the Oakland Public Library.

* Forms also available in Chinese, Vietnamese, Spanish or Braille. All versions except Braille are on the library's website at oaklandlibrary.org, under Disability Services.

OCTOBER, 2007