Library Card Application Form and User Responsibilities

Card Application

To complete this application, bring a printed copy of this completed form with one proof of address (driver’s license, utility bill, rental lease agreement, passport, or vehicle registration) to the library’s circulation desk.  For your convenience, blank forms are available at the library.  Applications to our library are free.

The York Public Library is also a member of the state NebrasKard system. Patrons wishing to use Kilgore Memorial Library through this system will be asked to present the NebrasKard label or key fob with their home library card and complete an application form for a York card.  York patrons who wish to use their card at other libraries need to ask for a NebrasKard sticker for their card.

Please print legibly. All personal information is considered confidential.

Last Name First Name
Date of birth □ Check if address is rural (not in city limits)
Street Address
City State Zip
Primary Phone cell       home
Email address
Registered User Responsibilities

Registered patrons are responsible for their library card. If your card is presented for circulation of materials it will be assumed you want to be responsible for the items and have granted permission for your account to be used.

If you believe your card is lost or stolen report it to the library.

Any communication about items on your account more than one week overdue will be made to the address recorded in our patron database. If your address changes it is your responsibility to update your records at the library. You may verify the address on your account in person or online at  Ask staff for details.

Patrons who wish to continue using their account will be asked to verify their address and telephone number annually. Accounts not used for three years will be deactivated and the application process will be required to renew.

The library has the ability to notify you by the method you select for the following reasons:

Reserve or ILL items are available, Items will be due in 3 days, Items are 3 days overdue

□ Text                    □ Email                   Please call me at the phone number I have listed above.

All patrons will receive mailed notices when items are 7 or more days overdue

By signing below you agree to comply with the policies of the Kilgore Memorial Library.  This includes presenting your library card (full card, key fob, or mobile device with app open and your barcode displayed) for each circulation transaction requested.


Signature of card holder, if card is for a patron under 16, signature of parent or guardian is required.



Signature of parent or guardian who will be responsible for all items and fees assessed on this account.


For Library Use:
Entered by, Initials Card number: 23001000 _   _  _   _ _ _ Scanned by, initials




    • If you already have a library card from the public library in York then you can simply stop in and we will update your account with your new card number and give you your new card. If you have never had a card from our library then you will need to print the application form found on our web site, fill it in and bring it in with your driver’s license or some mail showing your name and address. Or bring your proof of address documents to the library and ask for an application form at the main desk. We hope to see you soon!

Leave a Reply

Your email address will not be published. Required fields are marked *