Welcome Neighbor

Card Number*

Enter the 14-digit number on the backside of the library card you received.

Confirm Card Number*

Name*

First Full Middle Last

Date of Birth*

Preferred Language*

English
Spanish

Sex*

Male
Female
N/A

Address*

Street Address Apartment / Lot / Unit City State / Province / Region ZIP / Postal Code

Email*

Phone*

The best number at which to reach you. If you wish to receive notifications via text, please list your cell phone number here.

Notice Preference*

Email
Phone call
Text message

Standard text messaging rates may apply based on your plan with your mobile phone carrier. Text message delivery is subject to your mobile carrier network availability, so delivery is not guaranteed. You may opt out of text delivery at any time by replying STOP to any text message from Elkhart Public Library

Cell Carrier*

If you have selected text messaging as the preferred method of communication, we need to know which carrier through which to send the message.

Proof of Residency*

Elkhart Public Library requires identification to fulfill card requests. The information supplied must have an address matching the information provided on this form. Acceptable identification includes: • Driver’s license with photo • State or local identification card with photo • Passport or Country of Origin ID with photo • Check with imprinted name and address • Bank statement issued within the last two months • Property tax bill issued within the last year • Current rental agreement issued within the last year • Utility bill issued within the last two months • Vehicle registration issued within the last year • School identification card • Report card • Birth certificate • Parent/legal guardian identification

Drop files here or

Accepted file types: jpg, gif, png, pdf, Max. file size: 64 MB, Max. files: 2.

Personal Photo*

For your account security, please upload a photograph of yourself. Think passport or driver’s license photo, but we’ll accept a selfie, profile picture, etc.

Accepted file types: jpg, gif, png, pdf, Max. file size: 64 MB.

Consent*

I agree to the following library cardholder terms.

By checking this consent box, I acknowledge the information provided on this form is true and accurate. Additionally:

• I agree to use my library card and only my library card.
• I agree to the care and return of all library materials borrowed on the card.
• I agree to pay fees for any damaged, missing or lost library materials.
• I agree to report immediately changes in my address, email and/or phone number.
• I agree to report immediately if my library card is lost.
• I agree to abide by the Elkhart Public Library Code of Conduct and observe all Elkhart Public Library policies, procedures, rules and regulations.

Electronic Signature of Cardholder*

This field serves as your signature for online registration.

First Last

Electronic Signature of Parent/Guardian

Please complete if the applicant is under age 18 and identification provided is for parent/guardian.

First Last

CAPTCHA

New Property Owner Registration