Library Card Application

The following service is an application for a  Peoria Public Library Card.  This application does not automatically sign you up for a library card here on-line. Upon completion, print the application, apply your signature, and then bring the application plus 2 forms of identification, a picture I.D., and proof of address within Maricopa County, to the front desk of any  Peoria Public Library.

Please enter your name:

* First name
* Middle initial
* Last name

* Indicates a required field

Please provide the following contact information:

* Residence address
* City
* State/Province
* Zip/Postal code
* Home Phone  --
Work Phone  --
* Mailing address
* City
* State/Province
* Zip/Postal code
E-mail

     Drivers License Number

* Age Group: 
Choose one of the following options:

Juvenile 4 -13
Young Adult 14 -17
Adult 18 - 54
Senior 55+
I certify that the above information is correct. I agree to comply with all the library rules and regulations, to pay for loss or damage of library materials, and to give immediate notice of change of address or loss of library card. When necessary, the library may use the services of the collection department to retrieve fines and overdue materials. Responsibility for the choice of materials borrowed rests with the person whose signature appears below and not with the library system.



Signature of Card holder ________________________________

IF YOU ARE UNDER 18 YEARS OF AGE , PLEASE HAVE YOUR
PARENT / GUARDIAN HELP YOU COMPLETE THIS SECTION:

Attention: Guardian / Parent , Please Read the following:  
In addition to the information provided by the child or his assistant,
this application must by signed by the applicant's parent or guardian.
By endorsing this application you assume full responsibility for any
accrued fines and charges, or replacement costs, for overdue, damaged,
or lost items incurred by the child, regardless of how the overdue, damage,
or loss occurred. The adult cosigner is responsible for the library materials
from the time the child checks them out until they are safely returned to the
library. Because this is a serious responsibility, neighbors, friends,
older siblings, etc. are ENCOURAGED NOT TO SIGN
on behalf of the parent or guardian.

Name of Responsible Party ( Parent or Guardian )

* First name
* Last name

Parent/Guardian Address:

* Address
* City
* State/Province
* Zip/Postal code