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    Educator Card Registration Form

    Uploaded by

    Tony Ross
    This educator card registration form collects contact information from educators to allow them borrowing privileges at the DC Public Library. It requests the educator's name, birthdate, school and address information, phone numbers, and email. It outlines the card privileges which include borrowing books from children/young adult collections for classroom use. It notes the educator is responsible for all materials checked out and must return them promptly, and failure to do so could result in suspension of privileges or legal action. The form must be signed and dated.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd

    Educator Card Registration Form

    Uploaded by

    Tony Ross
    70 views1 page
    This educator card registration form collects contact information from educators to allow them borrowing privileges at the DC Public Library. It requests the educator's name, birthdate, school and address information, phone numbers, and email. It outlines the card privileges which include borrowing books from children/young adult collections for classroom use. It notes the educator is responsible for all materials checked out and must return them promptly, and failure to do so could result in suspension of privileges or legal action. The form must be signed and dated.

    Original Description:

    DC Public Library - Educator Card Application

    Copyright

    © Attribution Non-Commercial (BY-NC)

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    This educator card registration form collects contact information from educators to allow them borrowing privileges at the DC Public Library. It requests the educator's name, birthdate, school and address information, phone numbers, and email. It outlines the card privileges which include borrowing books from children/young adult collections for classroom use. It notes the educator is responsible for all materials checked out and must return them promptly, and failure to do so could result in suspension of privileges or legal action. The form must be signed and dated.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    70 views1 page

    Educator Card Registration Form

    Uploaded by

    Tony Ross
    This educator card registration form collects contact information from educators to allow them borrowing privileges at the DC Public Library. It requests the educator's name, birthdate, school and address information, phone numbers, and email. It outlines the card privileges which include borrowing books from children/young adult collections for classroom use. It notes the educator is responsible for all materials checked out and must return them promptly, and failure to do so could result in suspension of privileges or legal action. The form must be signed and dated.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
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    Fill in barcode______________

    Librarian’s initials ______

    Educator Card Registration Form

    (Please Print) _________________________


    Name: Birth Date (Month Day Year)

    ________________________________________________________________________
    Last Name First Name Middle Initial

    School:
     Preschool □ Elementary □ Secondary □ Home school □ Summer
     Other______________________________________________________________

    ________________________________________________________________________
    School Name Principal’s name

    ________________________________________________________________________
    Street Address

    ________________________________________________________________________
    City State Zip Code Ward

    Telephone numbers: Work: __________________ Home: _____________________

    To place a reserve, renew book, or receive email announcement please provide email.

    Email address: __________________________@_______________________________

    Home:
    ________________________________________________________________________
    Street Address

    ________________________________________________________________________
    City State Zip Code Ward/County

    Statement of Educator Card Privileges and Responsibilities


    This card enables the registrant to borrow books from the children and young adult collections for
    classroom use only. It is valid at any D.C. Public Library.
    Registrant is responsible for all library materials checked out using this card.
    All materials should be returned promptly. Failure to return materials or replace damaged or lost
    items can result in suspension of borrowing privileges. The library may resort to legal action to
    retrieve overdue materials or obtain payment for lost or damaged materials.
    Lost cards and changes in school, home, or email address, should be reported promptly.
    There is a replacement charge for a lost card.
    The card is the property of the D.C. Public Library.
    DCPL is not responsible for lost, stolen, or abandoned cards.

    ________________________________ _______________________________
    Signature Date

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