Finkelstein Memorial Library Membership Application

Membership Application
JUV CARD / SCHOOL FORM

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I hereby apply for a library borrower’s card for my child and agree to comply with all Library policies and regulations, including:

1. Paying fines and other charges promptly;

2. Giving immediate notice of loss of card, change of address, telephone number or email address;

3. Using only the card issued to me and not loaning my card to unauthorized users;

4. Being responsible for materials borrowed by minor children for whom I am parent or guardian.
***If you already have a library card, you need not apply again. If you have lost your library card, please contact the library. (845) 352-5700 X250***
Student ID Number*
PRINT PARENT'S NAME:
PARENT'S SIGNATURE:*

Clear
Name*

FIRST NAMEMIDDLE INITIALLAST NAME
ADDRESS*
APT. NUMBER
Birth Date*

MonthDayYear
Date
CITY/VILLAGE/TOWN
ZIP CODE
TELEPHONE
EMAIL
example@example.com
School*
Grade*
TEACHER*
Would you like to receive emails regarding library closures, news and events?*

YESNO
Would you like to receive OVERDUE notices via:*

EMAILPHONE
Would you like to receive HOLD notices via:*

EMAILPHONETEXT***To receive text notifications you must provide an SMS capable phone number (above). Your carrier may charge a fee.
Yes
I give my child permission to use the internet at the library (for children under the age of 14)*

YesNo
Should be Empty:

Membership Application