T. B. Scott Free Library 106 W. First St.; Merrill, WI 54452  715-536-7191
Your library since 1891 

 

T. B. Scott Free Library - Merrill, WI 54452
APPLICATION FOR ADULT LIBRARY CARD
This form is for applicants 18 years of age or older.

PLEASE PRINT:

Date:________________________

Name:_______________________________________________________________     
          (last)                                            (first)                         (middle intial)

Date of Birth_________________________________       Circle one: M   F

Address ____________________________________________________

City ___________________________________    State ____  Zip ____________ 

Phone (       )                        

County & Township _____________________________________________________________
                                  (county)                                   (township)

Drivers License ______________________________________

I apply for the right to use the library.  I agree to comply with all the library rules and regulations.

__________________________________________________________________
Signature    -   Sign full name

Previous or Other Last Name __________________________________________  (Staff _____)

AUTHORIZATION FOR E-MAIL NOTIFICATION (OPTIONAL)

___ Please notify me by e-mail of my items on hold and overdue items
___ Please send me Library news by e-mail when available

E-mail name_______________________________ E-mail address______________________________________
By signing I understand that I will NO LONGER receive any notification by mail.

Signature:_____________________________________________________________

Bring to library with current identification.

 

      Home      ~ T. B. Scott Free Library (Merrill Public  Library)  ~ Merrill, WI 54452 ~  
       ~ Wisconsin Library of the Year 1977 & 2002
  ~ Member of WVLS (Wisconsin Valley Library Service) Updated Oct4, 2012c.2001-2011                     

godaddy tracker