Warrenville Public Library District

First Name

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Last Name

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Middle Name

Parent or Guardian's Name (if applicable)

Gender

male female

Street Address

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Street Address Apartment Number

Mailing Address (if different)

Mailing Adress Apartment Number

City

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Zip

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Home Phone Number

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eMail Address

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Date of Birth

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Notification by

email phone

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I apply for the right to use the Warrenville Public Library District and agree to comply with all its rules and regulations. I am aware that there are no age restrictions on borrowing any library materials and I accept the responsibility for my child's selection of materials. I understand that I am responsible for all materials checked out on this card, and for any charges, costs or fees that may result from the late return, loss, or damage of materials borrowed. (check box if you agree) *