Public Services – 314F
ST. JOSEPH PUBLIC LIBRARY CARD APPLICATION
Minors (Birth to 17 years old)
Please print legibly
Name:________________________________________________________________________
         (FIRST)       (MIDDLE)         (LAST)
Date of Birth:_________________
Name:________________________________________________________________________
         (FIRST)       (MIDDLE)         (LAST)
Date of Birth:_________________
Name:________________________________________________________________________
         (FIRST)       (MIDDLE)         (LAST)
Date of Birth:_________________
Name:________________________________________________________________________
         (FIRST)       (MIDDLE)         (LAST)
Date of Birth:_________________
Name:________________________________________________________________________
         (FIRST)       (MIDDLE)         (LAST)
Date of Birth:_________________
Name of Parent or Legal Guardian:____________________¬¬-______________________________
Parent/Guardian Address: ________________________________________________________
(STREET, INCLUDING APARTMENT)
       _________________________________________________________
(CITY, STATE & ZIP)
Parent/Guardian Email Address for library notices:_____________________________________
Parent/Guardian Phone #:________________________________________
How would you like to be notified for reserved items and library notifications for your minor?
Phone ______     Email _______    Text _______ (#_____________ mobile carrier __________________)
______________________________________________________________________________
Parent/guardian signature.  By signing, the parent/guardian is accepting responsibility for the items checked out by the minor(s).

 
 

ADULT ST. JOSEPH PUBLIC LIBRARY CARD APPLICATION
PLEASE FILL IN ALL INFORMATION
(Photo ID Required – bring completed application to the library, along with a Photo ID)
Name:_______________________________________________________________
(FIRST)(MIDDLE)(LAST)
Gender:_______   Date of Birth:____________
Address:____________________________________________________________
(STREET)(APT #)(CITY/STATE)(ZIP CODE)
Phone #: _____________________________________
Email Address to receive library notices:____________________________________
Second Contact (in case of emergency):
____________________________________________________________________
(NAME)                                (PHONE NUMBER)                          (RELATION TO YOU)
____________________________________________________________________
Signature. By signing, you accept responsibility for the items checked out on the card.