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Georgetown Township

contact@georgetown-mi.gov

1515 Baldwin St, PO Box 769, Jenison, MI, 49429-0769, US

616-457-2340

Document Signers
    • 1 Library Patron

    • 2 Physician/Nurse/Social Worker

SeamlessDocs

This application for Homebound Delivery Services is to be filled out by the library patron, and requires certification from a physician, nurse, or social worker. Your physician, nurse, or social worker can be invited to sign via email when you finish your part of the application and click "Submit."

Your application will not be processed until it is certified.
By continuing I agree that I am willing to complete a digital version of the document(s) and that information about my user session will be stored.
Signature HereClick to Sign
09/25/2021Click to Sign
Signature HerePhysician/Nurse/Social Worker Will Sign Here
09/25/2021

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