CWC Library Card Application Form
Email *
First Name *
Middle Initial *
Last Name *
CWC ID # (7 digits) *
Date of birth *
Library Barcode # (on back of CWC ID) *
CWC Affiliation *
CWC email address
Phone number *
Alternate phone number *
Local mailing address: line 1 *
Local mailing address: line 2
Local mailing address: City *
Local mailing address: State *
Local mailing address: Zip/postal code *
Would you like our system to track your checkout history for you? *
Please enter your full name as your digital signature that you will be responsible for all materials checked out on your library card: *
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