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, passport, or vehicle registration) to the library’s circulation desk.  For your convenience, blank forms are available at the library.  Applications from patrons residing in York County are free.

Applications from patrons outside of York County will be assessed fees based on the length of membership requested. The current fee structure for this level of membership is set at: one Year $30, six months $20, one month $10.

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 submit the NebrasKard Library Customer Registration Form and Borrower Agreement in lieu of this form.

Please print legibly. All personal information is considered confidential.

Last Name First Name
Street Address
City State Zip
Primary Phone For cell phone list provider
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 https://york.biblionix.com/catalog/.

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                      □ Text                    □ Email                  □ No thank you

If you select no above, library staff will call you at your registered primary telephone number

Items will be due in 3 days                                       □ Text                    □ Email                  □ No thank you

Items are 3 days overdue                                         □ Text                    □ Email                  □ No thank you

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 and York City Code 24-28.2.  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

2 Comments

  1. GRANADA DOOLEY

    DO I NEED TO FILL OUT INFO FOR A NEW CARD?
    THE PLACE ABOVE DOES NOT ALLOW FILLING IN.

    • 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!

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