Question

how to write application for renew library card

Answer 1

LIBRARY CARD APPLICATION • SOUTH CENTRAL LIBRARY SYSTEM IDENTIFICATION REQUIRED:  Photo I.D. (i.e. Driver’s license, state I.D. card)  Proof of Current Address (i.e. Driver’s license, state I.D., recent mail, check book) PATRON INFORMATION (please print): Name: ______________________________________________________________________________________________ Last First Middle Birthdate: ____ /____ /____ Female Male Age Group: 0-17 18-61 62+ Month Day Year Mailing Address: _____________________________________________________________________________________ Street, RR/Fire Number or P.O. Box City or Village State Zip County of Residence: ________________________ Township: _________________________________ (if outside city/village limits) Residential Address: (Complete if different from mailing address) ___________________________________________________________________________________ Street, RR/Fire Number or P.O. Box City or Village State Zip Primary Phone*: (____) ________________________ Email Address: _________________________________________ Secondary Phone: (____) __________________________ Extension: ____________ I would prefer to be notified of my holds by: Email Phone* Text Library (or bookmobile stop) where I would prefer to pick up my holds: _______________________ (Library) ACCEPTANCE OF RESPONSIBILITY (Read carefully!)  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 dependents what resources are appropriate for my/our personal use. PATRON SIGNATURE:_____________________________________________ Date: ______________________ FOR JUVENILES (AGE 0-13), PLEASE COMPLETE: Parent or Legal Guardian Signature:_____________________________________________________________________ Please print Parent or Legal Guardian Name: _____________________________________________________________ FOR LIBRARY STAFF ONLY: Type of registration: Staff initials/LIB verifying ID: _______________ New patron Address change Proof of current address Lost card Renewal Patron Category: _______________________ Name Change (Former name ______________________) PSTAT (Sort 1): _________________________ Photo ID type: __________________________ Send application to: ______________________ (optional) ID #: __________________________ Patron has been issued card with barcode ____________________________________ from _______. Issue a card with this barcode and mail card to patron (staple barcod

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