Nacogdoches Public Library Card Application (ages 15
and above)
1112 North Street
559-2970
Instructions:
Please print clearly and
return to the Nacogdoches Public Library along with proof of current address. Proof
of address examples: driver’s license,
voter card, utility bill, etc.
Name: Last
_________________________ First ____________________________________ Middle
Initial ____
Last (4) four digits of
SOCIAL SECURITY NUMBER: _________
Local Mailing Address: _______________________________________________
City: _______________________________________________ State: _____________ Zip Code: ____________
Telephone: _________________________________________________
E-mail Address: ___________________________ @
_____________________
§
I agree to be
responsible for all items on my library card or my campus ID and for all
accrued fees for lost or overdue items. I understand this includes those items charged through Reciprocal
Borrowing Agreement with Stephen F. Austin State University.
§
I understand that if my
card or Campus ID is lost or stolen I am responsible for all items charged
until such time as I report the loss to the Public Library’s Circulation Desk.
PATRON’S SIGNATURE: ___________________________________________________________________
**********************************************************************************************
1112 North Street
559-2970
Instructions:
Please print clearly and
return to the Nacogdoches Public Library along with proof of current address. Proof of
address examples: driver’s license,
voter card, utility bill, etc.
Name: Last
_________________________ First ____________________________________ Middle
Initial ____
Last (4) four digits of
CHILD’S SOCIAL SECURITY NUMBER: _________
Local Mailing Address: _______________________________________________
City: _______________________________________________ State: _____________ Zip Code: ____________
Telephone: _________________________________________________
Birth Date: _________________________________________________
Parent’s E-mail
Address: ___________________________ @
_____________________
§
I apply for the right
to use the Library, and agree to comply with all its rules.
§
The parent(s) or
guardian(s) of this minor child are responsible for all fines and lost items
accrued by the above-named child.
§
If the child’s library
card is lost or stolen, the parent is responsible for all items charged until
such time as the lost card is reported to the Public Library’s circulation
desk.
CHILD’S SIGNATURE: ___________________________________________________________________
LEGIBLE PARENT OR GUARDIAN
SIGNATURE: ____________________________________________________