Library Card Application

Name (Adults or Caregiver)

First Name

Last Name

Child or Teen Name

First Name

Last Name

Address

City/Town

State

ZIP Code

E-mail

Phone

Date of Birth (Adult/Caregiver)

Date of Birth (Child/Teen)

Contact me about materials on hold by:

E-mail

Phone

Text

If text, you must provide your phone service provider:

As a cardholder or guardian, I agree to follow the rules of all libraries in the Westchester Library System and to pay any fines or fees for overdue, damaged, or lost library materials borrowed on this card.

Signature:

Date

Bedford Hills Free Library

Library Card Application