Adult Library Card Application - McPherson Public Library

Name *

First

Middle

Last

(if Date Agreement

Preferred Name (If different than above)

Date of Birth *

Photo ID *

If this is not a current Kansas ID, you will be asked to show proof of current address.

Have you had a card with us before? *

Mailing Address *

Address Line 1

City

State

Zip Code

Please note: if you are not a current resident of Kansas, you will not be eligible for a library card through us.

Permanent Address (if different than mailing address - or if away from home for short period, such as if attending college)

Address Line 1

City

State

Zip Code

Preferred Phone #

Email Address

Preferred method for necessary communications: (please choose one) *

Must have preferred method filled out above.

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Select a 4-digit PIN number

If no PIN is entered here, your library card PIN will be set to the last 4 numbers of your phone number.

Agreement *

I accept responsibility for all materials borrowed on this library account. I promise to promptly pay all fines for overdue, lost, or damaged materials. I agree to follow all library rules, and I understand that my card may be revoked and my library privileges restricted if I fail to do so. I will report a change of address or lost card immediately. To accept this agreement, please sign below.

Signature

Clear Signature