I certify that the applicant named has requested library service and isunable to read or use standard printed material for the reason indicated above. If applicant is blind or visually handicapped, the applicant's name will be referred to the S.C.Commission for the Blind for other possible services unless this block ischecked. The following items may be borrowed. Check all you wish to receive. If not being usedfor recorded reading material provided by the S.C. State Libary, the Library of Congress, and its cooperating libraries, it must be returned to the S.C.State Library.
Equipment remains the property of the federal government.
Send only the specific titles I will request. Applicant reads English only. No postage necessary. Free Matter for the Blind and Handicapped. In the absence of any of thesecertification may be made by professional librarians or other professionals whose competence under specific circumstances is acceptable to the Library of Congress.