My Account   |   How Do I?   |   Contact Us
My Account   |   How Do I?   |   Contact Us

Playlist Questionnaire

* These items are required.

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

Listener information

Name *

Age

Telephone number *

Caregiver information

Name *

Telephone number *

Library barcode number (Listener or Caregiver) *

Listener's Music Preferences

Favorite type(s) of music
BluesBig BandsClassicalCountry/WesternJazzLatinoOldiesOperaR&BRock & RollReligiousShow Tunes

Other (be specific)

Favorite singers/performers

Who/what did you listen to when young?

Favorite hymns or other religious music

Favorite TV shows or movies

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

Anything else important (other likes/dislikes, etc.)

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 9:30-9 PM
Friday-Saturday 9:30-5 PM

 

 

HOURS Monday-Thursday 9:30-9 PM Friday-Saturday 9:30-5 PM

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

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