Library Card Registration Form
Please fill out this form completely then ask a staff member to complete your card.
First Name of Cardholder *
Your answer
Middle Initial of Cardholder *
Your answer
Last Name of Cardholder *
Your answer
If Cardholder is under 18 - Full name of parent or guardian
Your answer
Home Address *
Street Address, City
Your answer
Phone Number *
Best number to be reached
Your answer
Email Address (for library communication only) *
If no email address, type NONE
Your answer
Contact preference for holds *
Please check one box
Required
Date of Birth *
MM
/
DD
/
YYYY
BY CLICKING SUBMIT I HEREBY AGREE TO OBEY ALL THE RULES AND REGULATIONS OF THE PUBLIC LIBRARY, TO PAY PROMPTLY ALL FINES CHARGED AGAINST ME FOR THE INJURY OR LOSS OF BOOKS, AND TO GIVE IMMEDIATE NOTICE OF ANY CHANGE OF ADDRESS, PHONE, OR EMAIL.
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service