Library Card Request Form

NOTE: If you have a card with any public library in Jefferson, Dodge, Washington, Racine or Walworth counties, you already have a card with us and will not need to reapply.

If you are under age 18 your parent or guardian must sign your library card application in order for you to use the card.
When we receive this completed form we will issue you a library card number. You will need to select a password for your account. You can then use your library card number and password to place items in our library catalog on hold. When you come to pick up your hold items, please bring positive identification (drivers licence, passport, Wisconsin Identification Card). If your positive identification does NOT have your current address on it, you will also need to bring verification of your current address to complete the application to get your card. We will send your library card number to the email address you have indicated as quickly as possible. Please note that if the library is closed, there will not be anyone available to respond until we reopen.

If you do not bring this information, no card will be issued and you will be unable to check out your items.

All fields in this form are mandatory and must be filled in correctly.

Your name:
Your address:
Include street, city, state and ZIP code
Your township:
If you have a rural address
Your phone number:
Your birth date:
Password:
(any combination numbers or letters, 4 to 10 characters in length)
Your email address:

 
 
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