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: -- Select One -- Main Branch Taft Branch El Modena Branch

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:

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 -- Select One -- No Yes Please enter the word above in the text box below.