Online Library Card Registration Form

Please read the requirements carefully before applying

In applying for a library card at Albert Wisner Public Library for myself or my child, I agree that:

• I assume responsibility for the material checked out on this card.
• I understand that material returned late will be subject to overdue fines, and I will pay for all unreturned or damaged items charged to this card.
• I will not hold the Library responsible for any damage that borrowed items might cause to my equipment.
• My child has access to all Library materials and equipment made available for use in the Library. I understand that it is a parent's responsibility, not the Library's, to control what a child reads and views.
• I will abide by Library rules.  My child will abide by Library rules. Parents and guardians are responsible for their juvenile children while their children are at the Library. Children unable to look out for their own safety shall not be left unattended at the Library.  Under no circumstances will children 7 years or younger be left unattended at the Library.
• I understand that a $5.00 fee will be charged for replacing a lost library card.
• I am aware of AWPL Fines and Fees

Your card will be made up and kept at the Circulation Desk. Please have the necessary Identification (See Guidelines and Eligibility) with you when you pick it up.

First Name: *

Last Name: *

Middle Initial:

Year/Month/Day of birth: *

MonthJanFebMarAprMayJunJulAugSepOctNovDec

Day12345678910111213141516171819202122232425262728293031

Street Address: *

City/State: *

Zip: *

PIN # (Choose 4 digits): *

Phone: (Area code first): *

E-mail: *

School District in Which I Reside: *

Parent's Name (for child's card only):

CAPTCHA

This question is for testing whether you are a human visitor and to prevent automated spam submissions.

What code is in the image?: *

Enter the characters shown in the image.