Temporary Library Card Request CommentsThis field is for validation purposes and should be left unchanged.Name* First Middle Initial Last Email* Enter Email Confirm Email Mailing Address* Street Address Apt./Unit/Suite City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Birth Date*MonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Applications for individuals younger than 18 years old require a parent/guardian to pick up their card and convert it from temporary to permanent. Phone*Type of Phone* Cell Landline Wireless Carrier*AT&TT-MobileVerizonXfinityBell CanadaBell SouthBoost MobileCellular OneCellular SouthCingular (Now AT&T)Consumer Cellular – AT&TConsumer Cellular – T-MobileCredoCricketFidoFreedom MobileFreeUPGood2Go MobileGoogle FiGreatCallH2O WirelessHelioMetro by T-MobileMetroPCSMint MobileNextelPage PlusPure TalkUSAQ LinkQwestRepublic WirelessRogers AT&T WirelessRogers CanadaSafelinkSimple MobileSouthwestern BellSpectrum MobileSprintStraight Talk – AT&TStraight Talk – VerizonStraight Talk – T-MobileStraight Talk – SprintTelloTelusText NowTing MobileTotal WirelessTracfoneUltra MobileUNREAL MobileUS CellularUSA MobilityVirgin MobileVirgin Mobile CanadaWind Mobile CanadaVisible WirelessHow would you like to receive account notices?* Email Text Phone Call How would you like to receive account notices?* Email Phone Call Also send additional notice by Text? Yes No Allow others to pick up holds for you: Yes No List up to two names of those authorized to pick up holds on your behalf*Agreement By submitting this form I agree to abide by library rules of conduct and I accept responsibility for all materials borrowed on this card.
