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 Would You Like to Receive Emails About Upcoming Programs & New Services? YESNO *Acceptance (required) By clicking here, I hereby apply for a library borrower's card and agree to abide by the regulations of the library. *If YOU ARE UNDER THE AGE OF 18, please note your parent/guardian's full name (First Name & Last Name) **Please Note: The parent/guardian noted above: is responsible for all materials borrowed on this card until the borrower reaches the age of 18; approves the use of any library resources including, but not limited to, the library's public internet workstations; and that assures their child abides by the regulations of the library. **Please Note: For new borrowers under the age of 18, a Parent/Guardian Signature is Required to get a permanent card. We will issue a 30-day temporary card to you now & follow up with a letter to your home.