Borrowing & Internet Policies Application

Please note: This form can be picked up at the library. Ask at the front desk.

Ardmore Public Library

This is the form only. The complete policies and application brochure is available at the library’s circulation desk.

Residency: (Check any that applies)

County of residence

Name: _________________________________________________________

First name Middle initial Last name

Address: _______________________________________________________

City: ___________________________ State: ______ Zip: _______________

Phone: ___________________________ Cell carrier: ___________________

If applicable

Email: ________________________________________________________

Notification preference: Phone / Text / Email

Circle one

Gender: Male Female Prefer not to say Birthday: _____ / _____ / _____

Circle one Month Day Year

Under 18 years of age requires parent signature for internet permission:

Parent signature: _______________________________________________