NHFPL TEACHER CARD APPLICATION
Valid for teachers and those professionals working in New Haven Schools. Note: Teacher cards are issued for one academic year and expire September 30st of each year. As a professional courtesy, this card may also be used to check out personal items.
NAME:
(last name, first, m.i.)
Your answer
DATE OF BIRTH:
(mm/dd/yyyy)
Your answer
SCHOOL:
Your answer
CLASSROOM NUMBER:
Your answer
GRADE AND/OR SUBJECT AREA:
Your answer
SCHOOL ADDRESS:
Street Address (Include City, State, Zip code):
Your answer
CLASSROOM/WORK PHONE:
Your answer
SCHOOL EMAIL:
Your answer
HOME ADDRESS:
Street Address (Include City, State, Zip Code)
Your answer
HOME OR CELL PHONE:
Your answer
WHAT IS THE BEST WAY TO REACH YOU?
WHICH LIBRARY DO YOU USE MOST OFTEN?
I agree to assume responsibility for all materials borrowed on this card, including charges for lost and damaged materials, to report the loss, theft or abuse of my card immediately, to report changes in my account and to abide by the polices of the Library.
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms