Library Card Registration
Address: 296 Main Street Phone:(865)-992-7106
Email address *
Full Name (First and Last): *
Patron Level (please check one): *
Date Of Birth: *
School: *
Grade level: *
Address: *
Mailing Address (if different from above):
Phone: *
Secondary phone number:
I would prefer to be notified of my holds by: *
Title VI Survey information please mark one (optional):
Clear selection
Acceptance of Responsibility (READ CAREFULLY PLEASE):
-I will be responsible for all materials checked out on this card, including materials checked out by others with or without my consent, unless I have previously reported the loss of my card.
-I will report a lost or stolen card, or any change of personal information (name, address, phone, email), immediately.
-I will Comply with all Library rules and policies.
-I understand that there will be charges for overdue, lost, damaged and stolen library materials.
-I understand that the library provides access to a broad range of resources and that it is my responsibility to judge for myself and for my children or minor defendants what resources are appropriate for my/our personal use.
Do you agree to our Internet policy? If you are an adult filling out the form for a child by agreeing here you are allowing your child unsupervised internet access on the library Computers. Policy outlined here: *
I have read and understand the above list of statements: *
Please type your name in the line below: *
Today’s date: *
Parent or legal guardian please type your name here (if the card is for a juvenile aged 5-17):
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy