LIBRARY CARD SIGN-UPPlease complete this form to register for a new or replacement Moffat Library card. Be sure to fill in all the required fields. *LAST NAME (required) *FIRST NAME (required) *MIDDLE NAME INITIAL (required) *MAILING ADDRESS *STREET ADDRESS (required) *CITY (required) *STATE (required) *ZIP CODE (required) If mailing address is a P.O. Box please enter your physical street address below: *BIRTH DATE (required) *HOME PHONE (required) CELL PHONE *EMAIL ADDRESS (required) How Would You Like the Library to Contact You? Choose one. Home PhoneCell Phone CallCell Phone TextEmail *Acceptance (required) By clicking here, I hereby apply for a library borrower's card and agree to abide by the regulations of the library.