Apply for a Library Card

Apply for a Library Card
Will this Card be for an Adult or a Student?
Student Info
School Name
Teacher's Last Name
Student's Name

First NameMiddle NameLast Name
Parent/Guardian Name

First NameLast Name
Student's Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Your Info
Your Name

First NameMiddle NameLast Name
Your Email
example@example.com
Phone Number
Please enter a valid phone number.Format: 000-000-0000.
Your Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Please choose a four-digit PIN
Must be 4 characters
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Alternate Address
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Yavapai Library Network Agreement

* I agree to comply with all Library rules and regulations; to be responsible for materials borrowed from any Yavapai Library Network library with this card and for fees and fines incurred, including charges for lost and damaged Library materials; to give immediate notice of changes of address and loss of my Library card.

* Whenever necessary, the Library uses the services of a collection agency to retrieve overdue materials. In the event of loss or damage to Library materials, or uncollected late fines or charges, I agree to pay all costs of collection, including but not limited to reasonable attorney’s fees.

* I understand that my card will be accepted at all Yavapai Library Network libraries and my patron information will be accessible to staff at those libraries.
Should be Empty:

Apply for a Library Card

Student Info

Your Info

Alternate Address

Yavapai Library Network Agreement