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Get Library Card Application Form Pdf

My child is not permitted to borrow videocassettes and DVDs. PLEASE NOTE Internet Access Permission for Children form available upon request. This library card entitles your child complete access to all materials of the County of Los Angeles Public Library. This card is non-transferable. SIGNATURE OF APPLICANT If you do not want library notices or communications via email please choose one of these options Phone U.S. Mail FOR PARENT/GUARDIAN OF MINOR APPLICANT FIRST NAME OF PARENT/GUARDIAN LAST NAME OF PARENT/GUARDIAN ADDRESS OF PARENT/GUARDIAN if different from above DATE MOVIE ACCESS My child is permitted to borrow videocassettes and DVDs. My child is not permitted to borrow videocassettes and DVDs. PLEASE NOTE Internet Access Permission for Children form available upon request. County of Los Angeles Public Library LIBRARY CARD APPLICATION PLEASE PRINT CLEARLY LAST NAME FIRST NAME MIDDLE NAME MAILING ADDRESS APT. NO. CITY STATE ZIP CODE RESIDENCE ADDRESS if different from above TELEPHONE BIRTHDATE MONTH/DATE/YEAR Required LAST FOUR 4 DIGITS SOCIAL SECURITY NO. CALIFORNIA DRIVER LICENSE OR ID NO. EMAIL Minors give parent/guardian s email address I agree to be responsible for all materials charged on my library card to report a lost library card at once to observe library rules to pay promptly all charges and to notify the library of any name or address changes. This card is non-transferable. SIGNATURE OF APPLICANT If you do not want library notices or communications via email please choose one of these options Phone U*S* Mail FOR PARENT/GUARDIAN OF MINOR APPLICANT FIRST NAME OF PARENT/GUARDIAN LAST NAME OF PARENT/GUARDIAN ADDRESS OF PARENT/GUARDIAN if different from above DATE MOVIE ACCESS My child is permitted to borrow videocassettes and DVDs. My child is not permitted to borrow videocassettes and DVDs. PLEASE NOTE Internet Access Permission for Children form available upon request. This library card entitles your child complete access to all materials of the County of Los Angeles Public Library. I assume responsibility for library materials borrowed by this child from the County of Los Angeles Public Library. SIGNATURE OF PARENT/GUARDIAN STAFF USE ONLY COST CODE BARCODE PROFILE ADULT CHILD QUALIFIER and DIRECT LOAN CODE USER CATEGORY UNICORP CITYSERVD OUT OF STATE NONRESDNT CANONCNTY QUICK REGISTRATION SAM INPUT BY 11/15 MCMEXICO VIP STAFF APPLICATION CHECKED TEEN TEENNOVID CHILD NOVID FINEFREE MCKOREA MCARGENTI FULL REGISTRATION INPUT AND FINAL REVIEW. County of Los Angeles Public Library LIBRARY CARD APPLICATION PLEASE PRINT CLEARLY LAST NAME FIRST NAME MIDDLE NAME MAILING ADDRESS APT. NO. CITY STATE ZIP CODE RESIDENCE ADDRESS if different from above TELEPHONE BIRTHDATE MONTH/DATE/YEAR Required LAST FOUR 4 DIGITS SOCIAL SECURITY NO. NO. CITY STATE ZIP CODE RESIDENCE ADDRESS if different from above TELEPHONE BIRTHDATE MONTH/DATE/YEAR Required LAST FOUR 4 DIGITS SOCIAL SECURITY NO. CALIFORNIA DRIVER LICENSE OR ID NO. EMAIL Minors give parent/guardian s email address I agree to be responsible for all materials charged on my library card to report a lost library card at once to observe library rules to pay promptly all charges and to notify the library of any name or address changes..

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