Join the Ocean County Library


Please follow these simple directions:
1. Click on the Printer to print out this form.print this page
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

ID#:  
Branch:  
Date:  
NAME

1

 Last:   First: M.I.:
OCEAN COUNTY ADDRESS

2

 #, Street:
  RD, P.O. Box:
3 Boro, Town or City:
4 Zip Code:

5

 Adult Community:
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:
11 City: State:
12 Zip Code:

13

 County:

SEX

 (Circle one)           M           F
AGE (Circle one)       0 - 5      6 - 13       14 - 17      18 - 54       55 - 64      65+    
16 Birthdate mm/dd/yyyy :
27 PIN Number:

29

 E-Mail Address:

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:

14

 Name of Parent/Guardian (Print):

8/99

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Disclaimer. All rights reserved. Revised: Monday December 09, 2002

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