application form

Last Name

Legal First Name

Full Middle Name

Preferred Name if different

Birth Date

Parent / Legal Guardian (for applicant under 18)

Mailing Address

City

State

Zipcode

Email Address

Phone

Preferred Contact Method Preferred Contact Method Text Message Phone Call Email

Street Address (if different from above)

City

State

Zipcode

Add a 4 digit PIN# (to access account online)

Would you like to receive library news and updates? Would you like to receive library news and updates? Yes No, Thank you.

Would you like to link this account to other cardholders? If yes, please enter the full name(s) of up to three (3) household members. Would you like to link this account to other cardholders? If yes, please enter the full name(s) of up to three (3) household members. Yes No, Thank You

You may enter up to 3 cardholder names to link with your account

Would you like to allow someone else (partner, spouse, etc.) to pick up your held items without you present? Would you like to allow someone else (partner, spouse, etc.) to pick up your held items without you present? Yes No, Thank You

You may enter up to 2 names to authorize them for picking up your held items.

Your Library Responsibilities: I hereby apply for the right of borrowing privileges at libraries within the MORE library consortium. I agree to comply with library rules and regulations, to pay all fines, to make good any damage to books or materials incurred by me, and to give immediate notice of any change of residence. In the event my library card is lost or stolen, I understand that I am responsible for charges on my account until the date the library is notified of its loss or theft. Your Library Responsibilities: I hereby apply for the right of borrowing privileges at libraries within the MORE library consortium. I agree to comply with library rules and regulations, to pay all fines, to make good any damage to books or materials incurred by me, and to give immediate notice of any change of residence. In the event my library card is lost or stolen, I understand that I am responsible for charges on my account until the date the library is notified of its loss or theft. Yes

Parent / Guardian: If signing a library card application for a juvenile, I accept responsibility for fines and charges on that child's card and acknowledge that it is my responsibility, not the library's, to monitor and approve my child's choice of library materials and/or other information resources. I understand that I can request library records for my custodial child/ward under the age of 16 (WI statute 43.30). Parent / Guardian: If signing a library card application for a juvenile, I accept responsibility for fines and charges on that child's card and acknowledge that it is my responsibility, not the library's, to monitor and approve my child's choice of library materials and/or other information resources. I understand that I can request library records for my custodial child/ward under the age of 16 (WI statute 43.30). Yes Not Applicable