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Electronic Library Card Application

Fields in Red are Required.

Library Card Applicant
Last Name:
First Name:

MI:

Birthdate (MM/DD/YYYY): :

Gender: Male

Female
I would like to pick up my library card at:

Residence

Mailing Address:
City:
State:
ZIP:
Primary Telephone:
Secondary Telephone:
E-Mail Address:

If the Mailing Address is a PO box, an Alternate Address is required.

Alternate Address:
City:
State:
Zip:

Identification
CA Driver's License or ID Number:
If the applicant is less than 18 years old, the Parent or Guardian must have, or be applying for, a library card and must provide their name, date of birth, and ID number above.
Parent/Guardian Last:
Parent/Guardian First:
Parent/Guardian D.O.B. (MM/DD/YYYY):

By checking "Accept" I certify that I have read and understand the following conditions:

I am responsible for the proper care and return of all library materials borrowed with the card issued to me. I understand that library cards are not transferrable and lost or stolen cards are to be reported immediately. I am responsible for any materials borrowed up to the time I notify the library that my card has been lost. I understand that as a parent, I am responsible for materials borrowed by my children. I understand that unresolved accounts may be turned over to a collection agency. At that time, I become responsible for any fees assessed by the collection agency. I also understand that overdue and fines due notices are sent as a courtesy and a lack of notice does not absolve me of the responsibility for returning library materials and paying any fines due.

Accept

Please enter the word above in the text box below.


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