Library card application

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  • Publicado : 8 de junio de 2011
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Last Name _____________________________First Name___________________________ Card Number _____________________________

Library Card Application
Applicant Information
Last Name: _____________________________________________ Home Phone: (___)______________________ First Name: __________________________________ M.I.: ______ Work Phone: (______)_______________________________________________________________________________ E-mail address: ____________________________________________________________

____________________ Mailing Address of Borrower or Parent/Guardian: Street Address or P.O. Box: ___________________________________Apartment Number: ___________________ City: ____________________________________________State: _________________Zip Code: _______________

S t a f f

U se

O n l y

S t a f f
Adult___

U s e
Teen____

O n l y
Child____

Resident of Hays County (no charge) ___YES ___NO If no – Card issued ___3 month temporary card – $5.00 ___permanent card – $14.00 Expiration date _________________________
Identification verified? Staff Initials: ___YES ___NO ____________

Computer agreement ___YES ___NO If minor, Computer use permission: ___YES___NO Parent/Guardian Name: (please print) ____________________________________
Permission to send newsletter? ___YES ___NO Permission to send due date notice by email? ___YES ___NO

Instructions To apply for a Dripping Springs Community Library card for yourself, complete this form and present it in person with a valid photo ID and proof of your current address. Valid photo ID’s must have anidentifying number. Examples: Driver’s License, TX DPS ID, Passport, Resident Alien Card. Proof of current residence includes Driver’s License, Department of Public Safety ID, personalized check, savings passbook, bank or credit union statement, voter’s registration, vehicle registration, liability insurance, rent receipt, utility deposit or utility bill. To apply for a Library card for a child ordependent: fill in the child’s/dependent’s name as borrower with your name in the parent/guardian area of the form. Provide child’s/dependent’s residence address. Provide a photo ID with an identifying number and proof of your current address in your name, as outlined above. Sign the application, assuming responsibility for all charges incurred against the card. The child/dependent should sign also,on the Borrower line. I agree to follow the Library Rules of Behavior, to accept responsibility for the use of Library computer resources, and to accept responsibility for all materials checked out on: My Card My Dependent’s Card

X_________________________________
Signature of Borrower

X_________________________________
Signature of Guardian (if applicable)

Last Name_____________________________First Name___________________________ Card Number __________________________

Library Policy Agreement
General Use
The Dripping Springs Community Library hopes that the people who use the library will find the facilities a warm, welcoming place to be, as well as a receptive environment for lifelong learning. The library encourages children of all ages to visit the library with theirparents to take advantage of the available resources. Library policies are designed to provide for the safety, security, and comfort of all people, regardless of age, using the Library. Library visitors and library personnel share responsibilities for maintaining this vital community resource just as they share its space and resources. Library visitors are required to observe these Library’srules of behavior and to accept responsibility for the use of the Library’s computer resources and for all materials borrowed Library staff stand ready to assist library visitors and to respond promptly to patron concerns guided by library policies and the underlying principles shaping those policies. Library policies are designed for the safety, security, and comfort of all those sharing the...
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