Library Membership Form

Calendar*

Membership Type*

New MemberParent / Guardian (select this option only if you are registering children under 18 years)

Full Name*

Address

Street Address:

City:

State:

Post Code:

Country:

Phone Number

Mobile

Email Address

Date of Birth

Additional Children (Under 18 years)

I do want to receive requests for customer feedback via

EmailSMS

I would like to receive electronically a Library Newsletter:

YesNo

Identification Required (Please enter the number of either your Drivers Licence, Passport or Medicare Card)

I accept Terms & Conditions:*

By ticking this box you are agreeing to the Library Membership Policy.

Type the code from the image:

The code you entered is not valid.

Type the code from the image