Library Card Request Form
Please fill out the following form to request a library card. We will mail your card to you. If you are under the age of 16, you will also receive a card to get a guardian's signature. You will also need to bring proof of identity to the library next time you visit us.
Library Location *
First Name *
Middle Initial
Last Name *
Address Line 1 *
Address Line 2
City *
State *
Zip Code *
Home Phone *
Business Phone
Township/Borough
County
Email address
Gender
Birth Date *
MM
/
DD
/
YYYY
Guardian's Name (if under 16)
Create a PIN or Password
Which style of card would you like? *
By checking this box, I understand and agree to the borrowing rules of my local library, to pay promptly all fines charged against me for the injury, loss, or late return of materials, and to give immediate notice of my change of address. *
Required
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