Please follow these simple directions:
1. Click on the Printer to print out this form.
2. Fill out the printed out form.
3. Bring this form and a valid I.D. for proof of address to your local branch.
For Staff Use Only
|OCEAN COUNTY ADDRESS|
|RD, P.O. Box:|
|3||Boro, Town or City:|
|6||Home Phone:||7||Work Phone:|
|8||Social Security# (optional):|
|9||School (is student):|
PERMANENT ADDRESS (If different from above)
|10||Street:||#, RD, P.O.Box:|
|(Circle one) M F|
|AGE||(Circle one) 0 - 5 6 - 13 14 - 17 18 - 54 55 - 64 65+|
|16||Birthdate mm/dd/yyyy :|
I agree to obey all the rules and regulations of the Ocean County Library and to give immediate notice of change of address.
|Signature of Applicant:|
FOR APPLICANTS AGE 13 AND UNDER
|I accept responsibility for all fines charged to my child, in accordance with all rules and regulations of the Ocean County Library. I also accept responsibility for the content of all material borrowed by my child.|
|Signature of Parent/Guardian:|
|Name of Parent/Guardian (Print):|
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Web Production Team.
Disclaimer. All rights reserved. Revised: Monday December 09, 2002