Cart Services Agreement – Form Cart Services Agreement Sno-Isle Libraries is looking forward to working with your facility as part of our outreach services program. We provide a monthly cart service to selected sites such as nursing homes, assisted living facilities, or senior housing where a significant number of residents are unable to travel to the library due to age or disability. Residents register for their own cards and are responsible for the library materials they check out. It is also possible to request deposit service for the facility. 1 Facility Information2 Contact Information3 Facility Requirements Checklist Facility Information Name of Facility Number of Units Current Number of Residents Facility Address Street Address Address Line 2 City ZIP / Postal Code Facility PhoneFacility Email Next Contact Person First Last Contact PhoneContact Email Who will assist library staff during the visit? Previous Next Facility Requirements for Cart Service Checklist Safe and convenient loading/parking space for a 25-foot van with wheelchair lift Unobstructed, easy access for wheeling cars into building (no curbs, steps, etc.) A room or space large enough to accommodate the library’s book carts (2-4 carts) and 2 staff, plus space for residents to comfortably browse and check out library materials. Designated table and electrical outlet for setting up and plugging in the library’s checkout computer, where electrical cords do not pose a tripping hazard. The minimum number of customers required to sustain cart service is 6 per site. Cart service may be discontinued if: usage declines, facility requirements are not met, or library materials are not consistently returned on time. Parking InstructionsBest Entrance to UseLocation of space or roomConsent I have read and understand all of the above information and the facility requirements for cart service.Submitter's Name First Last PhoneThis field is for validation purposes and should be left unchanged. Previous Close Can you tell me more about this webform submission? The contents of this webform are sent to library staff via email. We recommend that you do not submit confidential information (like your library card number, passwords or credit card information). If you need to share confidential information with library staff, we suggest that you use other channels of communication, such as the telephone.Visit our Privacy Statement, opens in a new window to learn more about how your personal information is handled and protected. This information will be submitted via email. Learn More about sending data over email. This iframe contains the logic required to handle Ajax powered Gravity Forms.