Common Contracts
1 similar Library Card Application contracts
GN/NON-MIX/TEMP/PP MAPPED PhoneLibrary Card Application • September 12th, 2022
FIRST MIDDLE LAST MAILING ADDRESS APT # CITY STATE ZIP HOME ADDRESS (IF DIFFERENT THAN ABOVE) CITY STATE ZIP PHONE # BIRTHDATE PIN (4 DIGITS) E-MAIL ADDRESS Please E-Mail me about Library news and events NOTICE PREFERENCEE-mail Phone Call 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 Proof of Address Yes No RESIDENCE AREA NOTES STAFF
