* Indicates required field

Applicant Details

Applicant First Name

Applicant Last Name

Applicant Date of Birth

dd/mm/yyyy

Phone

include area code

Mobile Phone

10 digits, starts with 0

Address

City

State

Postcode

Country

Are you applying on behalf of someone else?

YesNo

If the Applicant is less than 16 years of age then the Terms & Conditions must be accepted by a Legal Guardian.

Relationship

As you are applying on behalf of someone else please enter your details below.

Contact First Name

Contact Last Name

Home Phone

include area code if landline

Application Information

REFEREE

Library members need to provide contact details of a referee. We may contact the referee to certify the library member has a print disability.

A referrer may be a: diversional therapist, doctor, general practitioner, neurologist, nurse, nursing home staff, occupational therapist, ophthalmologist, optometrist, orientation and mobility instructor, orthoptist, physiotherapist, psychologist, public library staff, social worker, special education teacher, speech pathologist, or welfare officer.

Referee First Name

Referee Last Name

Organisation

Occupation

Phone

include area code if landline

Would you like to Access Feelix Storybook Kits:

YesNo

Would you like Braille Content?

YesNo

Are you currently or have previously received services from Vision Australia?

YesNo

Library Qualifying Reason

Are you a DVA Gold Card holder?

YesNo

DVA Gold Card Number

Gender

ACCESSING THE LIBRARY CATALOGUE

To access Vision Australia's online library you have the option to either

Use Vision Australia’s free app on your smart phone or tablet or other compatible device
Buy a Vision Australia mp3 player that will load books automatically when plugged into a computer ($75)

Free AppMP3 Player ($75)

PROOF OF DISABILITY (NOT MANDATORY)

To access the Bookshare Library service library members will need to provide written proof of disability from one of the following people: Doctor, ophthalmologist, optometrist, neurologist, learning disability specialist, psychologist with a background in disabilities, social worker, education Disability Student Services staff.

If you are unable provide it at this time please send to librarymembership@visionaustralia.org

Proof of Disability Documentation

Any further information about your child’s vision or interests

TERMS & CONDITIONS

In accordance with copyright requirements and partnership agreements, no unauthorised destruction, copying, reproduction, publication adaption, sale, rental, upload onto website or distribution to any other person or organisation of VAILS (Vision Australia Information Library Service) in terms or materials is permitted.

Library members agree to:

Comply with any specific restrictions or directions in relation to particular borrowed materials or items as advised by VAILS.
Return all items borrowed by the specified due date.
Provide details of a referee who may be contacted to certify the member has a print disability

By submitting this form you acknowledge that the information and documentation you have provided is accurate and you will abide by the terms and conditions.

Library Terms & Conditions Accepted

By submitting this form, you confirm that you agree to the storing and processing of your personal data by Vision Australia as described in our Privacy Policy. The information you have submitted will be used to provide you with the most relevant content on Vision Australia services, news & events, and other opportunities for support