Instructions for Completing the Individual Application

In compliance with federal regulations, every student using Wolfner Library books and equipment in a school setting must have a certified individual application on file with the library. To avoid delays in your student’s library service, follow the instructions below.

The student’s parent/guardian should complete the application (with the teacher’s assistance if necessary). Every student will be offered the option of library service in his/her home. The student can request a playback machine and books at home in addition to the materials he is using at school. The library will contact the parent upon receipt of the completed application.

• Complete the entire application. Do not skip any pages or sections.
  
• Provide the student’s full and complete legal name. The library’s database contains thousands of names; the possibility of duplication is real. Reassure parents that patron records are confidential and protected by Missouri state statute.
  
• Provide the student’s home address and telephone number, not the address and telephone number of the school. If a work phone number is included, indicate whose number it is (father, mother, student).
  
• Certified teachers, counselors, principals, librarians, registered nurses may certify a student’s application (page 2) EXCEPT in cases of a reading disability. The National Library Service requires the signature of a medical doctor or doctor of osteopathy when a student is applying on the basis of a reading disability only.
  
• A paraprofessional, teacher’s aide, etc. who is not a certified teacher may not sign as the certifying authority.
  
• The contact person named on page 5 should be a friend or a relative who is not a member of the immediate family. The contact should not be a teacher.
  
• The section on page 5, titled “Applicant Agreement,” must be signed by the student’s parent or legal guardian, unless the student is 18 years of age or older. The person who signs this is taking responsibility for the equipment and books sent to the student’s home.
  
• Do not fax the completed application because the library must have original signatures on file. Mail the original application to:

  Wolfner Library for the Blind and Physically Handicapped
  Attention: Youth Services Librarian
  PO Box 387
  Jefferson City, MO 65102-0387