Student Library Card Application (https://www.prescottlibrary.info/student-library-card-application/) Phone School Name * Teacher's Last Name * Student's First Name * Student's Middle Name Student's Last Name * Parent/Guardian First Name * Parent/Guardian Middle Name Parent/Guardian Last Name * Parent/Guardian ID # *Driver’s license #, State ID#, Passport # Student's Birth Date * Month Year Su Mo Tu We Th Fr Sa 25 26 27 28 29 30 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 1 2 3 4 5 Cancel OK Cursor keys can navigate dates Email * Phone * Please choose a four-digit PIN * Street Address * City * State * Zipcode * Alternate Address Street Address City State Zipcode Yavapai Library Network Agreement I agree to comply with all Library rules and regulations; to be responsible for materials borrowed from any Yavapai Library Network library with this card and for fees and fines incurred, including charges for lost and damaged Library materials; to give immediate notice of changes of address and loss of my Library card. Whenever necessary, the Library uses the services of a collection agency to retrieve overdue materials. In the event of loss or damage to Library materials, or uncollected late fines or charges, I agree to pay all costs of collection, including but not limited to reasonable attorney’s fees. * I understand that my card will be accepted at all Yavapai Library Network libraries and my patron information will be accessible to staff at those libraries.