Library Card Application

ADULT           ST. JOSEPH PUBLIC LIBRARY CARD APPLICATION
PLEASE FILL IN ALL INFORMATION
Photo ID Required – bring completed application to any branch, along with a Photo ID)

Name (First, Middle, Last):

Last 4 Digits Social Security #:               Gender:              Date of Birth:                          Phone #:

Address (Street Address, Apt. #, City/State & Zip Code):

Email Address to receive library notices:

Second Contact (in case of emergency) (FIRST NAME, PHONE NUMBER & RELATION TO YOU):

Signature:

By signing, you are accepting responsibility for the items checked out on this card.

 

 

JUVENILE      ST. JOSEPH PUBLIC LIBRARY CARD APPLICATION
PLEASE FILL IN ALL INFORMATION

Name (First, Middle, Last):

Last 4 Digits Social Security #:              Gender:               Date of Birth:                                Phone #:

Name of Parent or Guardian:

 

Parent/Guardian Address (Street Address, Apt. #, City/State & Zip Code):

 

Parent/Guardian Email Address to receive library notices:

Second Contact (in case of emergency and we can’t contact parent/guardian) FIRST NAME, PHONE NUMBER & RELATION TO JUVENILE):

Parent/guardian signature:

By signing, the parent/guardian is accepting responsibility for the items checked out by the minor.