Playlist Questionnaire

* These items are required.

If you would prefer to fill out a paper form, click here to download.

    Listener information

    Name *

    Age

    High school graduation year

    Telephone number *

    Caregiver information

    Name *

    Telephone number *

    Library barcode number (Listener or Caregiver) *

    Listener's Music Preferences

    Favorite type(s) of music
    BluesBig BandsClassicalCountry/Western*JazzLatinoOldiesOperaR&BRock & Roll*ReligiousShow Tunes*Other*

    *Oldies Decade 40s50s60s70s

    *Please be specific


    What songs did you dance to at your wedding or prom?

    When you were young, who/what were your favorite singers/performers (list 5-10)?

    Favorite hymns or other religious music:

    Anything else important (other likes/dislikes, etc.), or any other specific music requests:

    COMSEWOGUE PUBLIC LIBRARY
    170 Terryville Road
    Port Jefferson Station, NY 11776

    COMSEWOGUE PUBLIC LIBRARY
    170 Terryville Road
    Port Jefferson Station, NY 11776

    HOURS
    Monday-Thursday 9:30 am - 9 pm
    Friday-Saturday 9:30 am - 5 pm
    Sunday 12 noon - 4 pm
    HOURS
    Monday-Thursday 9:30 am - 9 pm
    Friday-Saturday 9:30 am - 5 pm
    Sunday 12 noon - 4 pm

    CONTACT
    Phone (631) 928-1212
    Fax (631) 928-6307

    Jobs

    CONTACT
    Phone (631) 928-1212
    Fax (631) 928-6307

    Jobs