Name: (Last, First, Middle Initial) Required Home Address: (House Number, Street Name, P.O. Box, City, State and Zip) Required Home Phone Number/Cell Number and Provider: Required Email Address: Required Type of Card: Family or Individual Required Notification Preference: (select best option) Required Email Phone Call/Voicemail Text *List of family members: (Family Card Only) Driver's License # Required Birthdate: (mm/date/year) Required Agree to terms and policies: Required I hereby agree to obey all the rules and regulations of the library, to pay promptly all fines charged for damage or loss of library materials in my possession and to give immediate notice of any change of address or phone number. Signature: (esign or sign in person when you pick up your card) Patron ID# (to be filled out by the library) Submit