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Temporary SMRLD Library Card Registration Form
This is for taxpaying residents of the Six Mile Regional Library District (anyone living in 62040).
A photo ID will be required on your next visit to the Library, either 2001 Delmar Avenue or 2145 Johnson Road. Your membership will be deactivated eight weeks from today if you are unable to make it to either location with a photo ID that shows your current address. Please allow 48 hours for a library card to be assigned to you.
Date of Birth
Home Phone Number
Go to the next question if you don't have a landline.
Cell Phone Number
Cell Phone Carrier
Who supplies your cell phone's service? AT&T, Verizon, T-Mobile, Sprint, Spectrum, etc. This allows us to send you text message notifications if you opt-in below.
How would you prefer to be contacted by the Library? You may choose more than one.
This is primarily for how we will contact you to notify your of your library card number as well as when items that are ready to be picked up. We will not share your personal information and will only contact you for item pickup or absolutely necessary communications.
Cell text message
Would you like to receive Library information via email?
We can send you emails that include what's new at the Library, program information, etc.
Driver's License or State ID Number
Please enter your Illinois Driver's License or State ID number.
Statement and Signature
Typing your full name below serves as your signature and verifies that you agree to the following statement: I understand that I am responsible for all use of my library card. I agree to comply with all the rules of the public library; to pay promptly all fines for overdue, damaged, or lost materials; and to give immediate notice of any change of address or lost card. I understand that the Internet-access terminals are not located in private rooms, and I waive any claim to confidentiality or privacy arising out of or involving use of the Internet through the Library.
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This form was created inside of Six Mile Regional Library District.