Library Membership Access Check-in
Please complete this form to check in and access library facilities. Your information helps us ensure a secure and welcoming environment for all members.
Full Name
*
First Name
Last Name
Membership Number
*
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Date and Time of Check-in
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Purpose of Visit
*
Borrow/Return Books
Study/Reading
Use Computers
Attend Event/Workshop
Other
Library Area/Section to Access
*
Please Select
General Collection
Children's Section
Reference Room
Computer Lab
Study Rooms
Event Hall
Other
Preferred Reading Genre
Fiction
Non-fiction
Science
History
Children's Books
Other
Do you require any special access or assistance?
No
Yes (please specify below)
If yes, please describe your special access or assistance needs
Emergency Contact Name
Emergency Contact Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Comments or Feedback
Check In
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