Teacher Library Card Application

How would you like to be notified when your card number is ready?*

Email (Please be sure to enter the correct email address in the box on this application form.)
Phone

Phone for notification*

Do you have a preferred time range for when you would like to be called?*

Yes
No

Start Time*

:

End Time*

:

Name*

First Last

School Mailing Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Personal Address

Street Address Address Line 2 City State ZIP Code

Phone (best number at which to reach you)*

Cell Phone

Work Phone

Email*

We will only use your email address to notify you of holds or items that are coming due.

Would you like to have a list of items checked out automatically emailed to you each time you check out?*

Yes
No

Would you like to be notified of available holds and items coming due by text message? (Please note that your carrier's messaging fees my apply.)*

Yes
No

If you would like to be notified via text, please enter your mobile phone number:*

If you would like to be notified via text, what is your mobile phone carrier?*

If you would like to sign up for The Brookfield Library's E-Newsletters, please indicate the categories you're interested in below:

Do you need to register to vote?*

Yes
No

Print and mail this form to the Registrar of Voters or register to vote online.
Imprima el formulario de registro de votantes en español.

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I apply for the right to use The Brookfield Library. I promise to comply with all its rules, to return items I borrow promptly, to promptly pay fines for overdue items borrowed on my card, and to reimburse the library for any items which are lost or damaged while in my care. I will immediately notify the library of any change in my address, telephone number, and/or email address. BY ENTERING YOUR FULL NAME IN THE BOX BELOW, YOU AGREE TO THE ABOVE STATEMENT.*

I agree to the following:

I apply for the right to use The Brookfield Library. I promise to comply with all its rules, to return items I borrow promptly, to promptly pay fines for overdue items borrowed on my card, and to reimburse the library for any items which are lost or damaged while in my care.

I will immediately notify the library of any change in my address, telephone number, and/or email address.

BY CHECKING THIS BOX, YOU AGREE TO THE ABOVE STATEMENT.

Monday & Wednesday: 10 a.m. - 6 p.m.	Tuesday & Thursday: 10 a.m. - 8 p.m.
Friday & Saturday: 10 a.m. - 5 p.m.	Sunday: 12 - 4 p.m.