Common Contracts

LINCC LIBRARY CARD APPLICATION

Library Card Application • September 18th, 2023

• Contract Type
  Library Card Application
• Filed
  September 18th, 2023

FIRST MIDDLE (FULL) LAST/SURNAME PREFERRED (FIRST NAME) MAILING ADDRESS APT/UNIT CITY STATE ZIP HOME ADDRESS (IF DIFFERENT THAN ABOVE) CITY STATE ZIP PHONE BIRTHDATE PIN (4 DIGITS) E-MAIL ADDRESS Please email me about library news and events! NOTICE PREFERENCEPHONE EMAIL TEXT AGREEMENT: I understand that I am responsible for all use made of my library card and I agree to abide by library rules. This card may be used at all public libraries in Clackamas County. Policies and offered services vary between libraries. Information about a member’s record cannot be given to anyone but the member. APPLICANT SIGNATURE DATE PARENT/GUARDIAN SIGNATURE PARENT/GUARDIAN PRINT BARCODE ID MAPPED Proof of AddressYes No GN/NON-MIX/TEMP/PP RESIDENCE AREA NOTES STAFF