New Patron Registration Form

NEW PATRON REGISTRATION FORM

* Indicates required field

Name *

First

Last

Address (Street, PO Box, Town, State, Zip) *

Line 1

Line 2

City

State

Zip Code

Country

Family: If this will be a shared family card please list names of others that may be using the account *

Residence in Hopewell Borough, Pennington, or Hopewell Township. Choose one: *

I do reside I do not reside

Primary Phone Number *

Secondary Phone Number *

Email *

I wish to receive news and information about the Hopewell Public Library via email: *

Yes No

I agree to obey all the rules and policies of Hopewell Public Library. I agree to be responsible for all fines, damages, losses, and costs charged against me. I realize I am responsible for all such charges against my library card until the date that written notice of its loss or theft is given to the library.

Signature *

Submit Patron Registration

FOR MINOR PATRONS ONLY

Patrons under 14 years of age must have a parent or legal guardian complete and sign this form.

* Indicates required field

Minor Patron's Name *

First

Last

Minor patron's birthday (Month/Day/Year) *

Full name of parent/guardian *

First

Last

Parent/Guardian mailing address *

Line 1

Line 2

City

State

Zip Code

Country

Parent/Guardian phone number *

Parent/Guardian email *

I understand that by signing on behalf of this minor child I am authorizing his or her full use of the library's facilities and collection. I agree to be responsible for all fines, damages, losses, and charges incurred by this minor.

Signature *

Submit Minor Registration