Temporary SMRLD Library Card Registration Form
Thank you for your interest in the Six Mile Regional Library District and its resources.  With a Library card, you can access all the electronic resources available through the Library's smrld.org website.  This includes electronic books, audiobooks, music, movies, research databases, and more.

Please allow 48 hours for a library card to be assigned to you.  As soon as you can, within 90 days of receiving your library card number, bring your photo ID that shows your current address to the Library at 2001 Delmar Avenue (our Johnson Road location is not currently open for in-person visits) to keep your card active and to be able to request and check out physical materials.  Your membership will be suspended 3 months from activation if you are unable to visit the Library in person.  
[Parents or guardians of minors will need to accompany their children to retrieve a child's Library card.]

The use of this form is for taxpaying residents of the Library District (anyone living in 62040).
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Last Name *
First Name *
Middle Initial
Date of Birth *
Home Address *
City *
Home Phone Number
Go to the next question if you don't have a landline.
Cell Phone Number
Cell Phone Carrier
Who supplies your cell phone's service?  AT&T, Verizon, T-Mobile, Sprint, Spectrum, etc.  This allows us to send you text message notifications if you opt-in below.
Email address *
How would you prefer to be contacted by the Library? You may choose more than one. *
This is primarily for how we will contact you to notify your of your library card number as well as when items that are ready to be picked up.  We will not share your personal information and will only contact you for item pickup or absolutely necessary communications.
Would you like to receive Library information via email? *
We can send you emails that include what's new at the Library, program information, etc.
Driver's License or State ID Number *
Please enter your Illinois Driver's License or State ID number.
Statement and Signature *
Typing your full name below serves as your signature and verifies that you agree to the following statement: I understand that I am responsible for all use of my library card. I agree to comply with all the rules of the public library; to pay promptly all fines for overdue, damaged, or lost materials; and to give immediate notice of any change of address or lost card. I understand that the Internet-access terminals are not located in private rooms, and I waive any claim to confidentiality or privacy arising out of or involving use of the Internet through the Library.
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